Organization
SPFLD URB EMERGENCY PHYSICIANS INC
Active
Other names
Spfld Urb Emergency Physicians Inc/Mercy Urbana
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM A COLE JR. MD (CEO)
(800) 726-3627
Entity
Organization
Contact information
Practice address
904 SCIOTO ST, URBANA, OH 43078-2226
(937) 653-5231
(937) 653-7551
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1371641
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000300375
GROUP PROVIDER NUMBER
OH
01
—
020407300
FEDERAL BLACK LUNG GRP#
OH
01
—
202821901
DEPARTMENT OF LABOR GRP#
OH
01
—
203424
EEOICP GRP PROVIDER #
OH
05
—
2418244
—
OH
01
—
C35743
HUMANA GRP PROVIDER #
OH
Enumeration date
08/15/2005
Last updated
04/20/2008
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