Organization
GREENE MEMORIAL HOSPITAL SERVICES INC
Active
Other names
Advanced Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY Y KO (CFO)
(937) 558-3208
Entity
Organization
Contact information
Practice address
10050 INNOVATION DR, SUITE 200, MIAMISBURG, OH 45342-4931
(937) 558-3208
(937) 558-3248
Mailing address
10050 INNOVATION DR, SUITE 200, MIAMISBURG, OH 45342-4931
(937) 558-3208
(937) 558-3248
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208200000X
Plastic Surgery Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
208M00000X
Hospitalist Physician
—
—
213ES0131X
Foot Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2639630
—
OH
01
—
DE7779
RAILROAD MEDICARE
—
Enumeration date
07/07/2006
Last updated
06/30/2014
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