Individual
DR. BILLY BACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
65 W MAIN ST, GREENWICH, OH 44837-1030
(419) 752-1811
(419) 752-2145
Mailing address
65 W MAIN ST, GREENWICH, OH 44837-1030
(419) 752-1811
(419) 752-2145
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35078984
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110219196
RR MEDICARE
OH
05
—
2227781
—
OH
Enumeration date
08/12/2005
Last updated
09/01/2016
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