Organization
CARILLON FAMILY PRACTICE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE M CHAVEZ MD (OWNER/PHYSICIAN)
(937) 643-3083
Entity
Organization
Contact information
Practice address
2501 S DIXIE DR, KETTERING, OH 45409-1523
(937) 643-3083
(937) 643-3089
Mailing address
2501 S DIXIE DR, KETTERING, OH 45409-1523
(937) 643-3083
(937) 643-3089
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2328529
—
OH
Enumeration date
12/29/2005
Last updated
12/17/2009
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