Organization
DARKE COUNTY INTERNAL MEDICINE-PEDIATRICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LYNNE HAWLEY MD (OWNER)
(937) 548-3868
Entity
Organization
Contact information
Practice address
130 WEST MARTZ STREET, SUITE 1, GREENVILLE, OH 45331
(937) 548-3868
Mailing address
130 WEST MARTZ STREET, SUITE 1, GREENVILLE, OH 45331
(937) 548-3868
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35069759
OH
208000000X
Pediatrics Physician
35069759
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2012253
—
OH
Enumeration date
04/18/2007
Last updated
08/13/2007
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