Organization
HOCKING VALLEY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY BROWN (CREDENTIALING SPECIALIST)
(740) 380-8350
Entity
Organization
Contact information
Practice address
601 STATE ROUTE 664 N, LOGAN, OH 43138-8541
(740) 380-8140
(740) 380-8150
Mailing address
PO BOX 228, LOGAN, OH 43138-0228
(740) 385-7564
(740) 385-7566
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
OH
207X00000X
Orthopaedic Surgery Physician
—
OH
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
OH
208000000X
Pediatrics Physician
—
OH
2084P0800X
Psychiatry Physician
—
OH
208600000X
Surgery Physician
—
OH
208D00000X
General Practice Physician
—
OH
363A00000X
Physician Assistant
—
OH
363AS0400X
Surgical Physician Assistant
—
OH
363L00000X
Nurse Practitioner
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023303500
BLACK LUNG
OH
05
—
0261756
—
OH
Enumeration date
09/21/2006
Last updated
08/20/2025
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