Organization
HEALTHSERVE PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C BOURLAND (CEO)
61493989110
Entity
Organization
Contact information
Practice address
153 W MAIN ST STE 103, NEW ALBANY, OH 43054-9225
(614) 939-9110
(641) 939-4857
Mailing address
2939 KENNY RD STE 200, COLUMBUS, OH 43221-2406
(440) 274-5000
(440) 716-8608
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
11/19/2015
Last updated
11/19/2015
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