Organization
NEW CARLISLE FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHOK P DEVATHA M.D. (PHYSICIAN)
(937) 846-4000
Entity
Organization
Contact information
Practice address
432 N MAIN ST, NEW CARLISLE, OH 45344-1427
(937) 846-4000
(937) 846-4004
Mailing address
432 N MAIN ST, NEW CARLISLE, OH 45344-1427
(937) 846-4000
(937) 846-4004
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35073686D
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2059883
—
OH
Enumeration date
03/21/2007
Last updated
04/04/2014
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