Organization
ANCILLARY SERVICES OF MIDDLETOWN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE BROWN (PRACTICE MANAGER)
(937) 291-7850
Entity
Organization
Contact information
Practice address
105 MCKNIGHT DR, MIDDLETOWN, OH 45044-4838
(800) 742-2368
(937) 291-2962
Mailing address
PO BOX 632412, CINCINNATI, OH 45263-2412
(800) 742-2368
(937) 291-2962
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0521126
—
OH
Enumeration date
01/23/2006
Last updated
08/22/2020
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