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Organization

MIDDLETOWN MEDICAL GROUP,INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL RUSSELL JENNEWINE MD (PRESIDENT)
(513) 424-2535
Entity
Organization

Contact information

Practice address
200 N BREIEL BLVD, MIDDLETOWN, OH 45042-3808
(513) 424-2535
(513) 424-0363
Mailing address
6850 SLOEBIG RD, MIDDLETOWN, OH 45042-9448
(513) 424-2535
(513) 424-0363

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2338625
OH
Enumeration date
01/18/2006
Last updated
08/22/2020
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