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Organization

MONTGOMERY FAMILY PRACTICE, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GINGER S KUBALA MD (PRESIDENT MD)
(513) 791-1201
Entity
Organization

Contact information

Practice address
10550 MONTGOMERY RD STE 11, MONTGOMERY, OH 45242-4495
(513) 791-1201
(513) 791-1231
Mailing address
10550 MONTGOMERY RD, # 12, CINCINNATI, OH 45242
(513) 791-1201
(513) 791-1231

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35057045
OH
207Q00000X
Family Medicine Physician
35067638
OH
207Q00000X
Family Medicine Physician
Primary
350728718
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2274891
OH
Enumeration date
11/08/2006
Last updated
01/11/2023
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