Organization
HEALTHSOURCE OF OHIO, INC.
Active
Other names
HealthSource: Georgetown Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH W PRATHER II MD (CEO)
(513) 707-4041
Entity
Organization
Contact information
Practice address
631 E STATE ST, GEORGETOWN, OH 45121-1437
(937) 378-6387
(937) 378-4253
Mailing address
424 WARDS CORNER RD STE 200, LOVELAND, OH 45140-6966
(513) 074-0417
(513) 576-1020
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0598349
—
OH
Enumeration date
09/11/2006
Last updated
09/18/2024
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