Organization
FAMILY MEDICAL CENTER OF LIMA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE S INGALLS M.D. (FAMILY PRACTICE)
(419) 227-7770
Entity
Organization
Contact information
Practice address
1220 E ELM ST, SUITE 150, LIMA, OH 45804-2850
(419) 227-7770
(419) 227-7783
Mailing address
1220 E ELM ST, SUITE 150, LIMA, OH 45804-2850
(419) 227-7770
(419) 227-7783
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000122247
ANTHEM BC/BS
OH
05
—
2030546
—
OH
01
—
289521867002
MEDICAL MUTUAL OF OHIO
OH
Enumeration date
08/22/2007
Last updated
03/26/2008
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