Organization
PAI PARTICIPANT 1 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL C FORD (AUTHORIZED OFFICAL)
(859) 291-4800
Entity
Organization
Contact information
Practice address
60 MARIETTA RD, CHILLICOTHE, OH 45601-9433
(859) 291-4800
Mailing address
PO BOX 639676, CINCINNATI, OH 45263-9676
(859) 291-4800
(859) 655-8588
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/13/2019
Last updated
02/25/2026
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