Organization
DR. DIRK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIRK NORMAN JUSCHKA M.D. (CEO)
(937) 402-1000
Entity
Organization
Contact information
Practice address
300 W SPRING ST UNIT 702, COLUMBUS, OH 43215-7651
(937) 232-8033
(937) 426-6576
Mailing address
PO BOX 609, LUCASVILLE, OH 45648-0609
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
314000000X
Skilled Nursing Facility
Primary
35.052815
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0616033
—
OH
Enumeration date
05/27/2011
Last updated
11/23/2021
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