Organization
FAMILY PRACTICE CENTER OF LOUISVILLE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CATHARINE J TABB M.D (PRESIDENT)
(330) 875-3353
Entity
Organization
Contact information
Practice address
1303 CALIFORNIA AVE, LOUISVILLE, OH 44641-8737
(330) 875-3353
(330) 875-2746
Mailing address
1303 CALIFORNIA AVE, LOUISVILLE, OH 44641-8737
(330) 875-3353
(330) 875-2746
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000164947
ANTHEM GROUP #
OH
05
—
0430528
—
OH
05
—
0434239
—
OH
05
—
2154476
—
OH
01
—
285505380-00
WORKERS COMPENSATION
OH
Enumeration date
05/24/2006
Last updated
07/21/2022
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