Organization
EASTSIDE INTERNAL MEDICINE-GERIATRICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JYOTI J MEHTA MD (PRESIDENT)
(513) 724-2226
Entity
Organization
Contact information
Practice address
1001 W MAIN ST, WILLIAMSBURG, OH 45176-1146
(513) 724-2226
(513) 724-5248
Mailing address
PO BOX 643113, CINCINNATI, OH 45264-0307
(513) 724-2226
(513) 724-5248
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3007721
—
OH
01
—
DO8367
RR MCR
OH
Enumeration date
01/23/2006
Last updated
03/25/2010
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