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Organization

LEWISBURG FAMILY PRACTICE, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL TODD BOGGS MD (PRESIDENT)
(937) 962-2618
Entity
Organization

Contact information

Practice address
405 W GRAND AVE, DAYTON, OH 45405-7538
(937) 395-6665
(937) 395-6668
Mailing address
PO BOX 578, LEWISBURG, OH 45338-0578
(937) 962-2618
(937) 962-4971

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35067136
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0169384
OH
Enumeration date
08/13/2007
Last updated
04/04/2018
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