Organization
MC PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES TAYLOR (STATUTORY AGENT)
(937) 304-5955
Entity
Organization
Contact information
Practice address
8885 WELLER RD, MONTGOMERY, OH 45249-2729
(937) 554-9144
Mailing address
8885 WELLER RD, MONTGOMERY, OH 45249-2729
(937) 554-9144
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35089261
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30796526400
OHIO WORKER'S COMPENSATION
OH
Enumeration date
01/18/2012
Last updated
06/24/2025
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