Provider Demographics
NPI:1649444886
Name:FAMILY PRACTICE OF DUBLIN, INC.
Entity type:Organization
Organization Name:FAMILY PRACTICE OF DUBLIN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:STOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-889-0989
Mailing Address - Street 1:5935 WILCOX PL
Mailing Address - Street 2:SUITE C
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-6797
Mailing Address - Country:US
Mailing Address - Phone:614-889-0989
Mailing Address - Fax:
Practice Address - Street 1:5935 WILCOX PL
Practice Address - Street 2:SUITE C
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-6797
Practice Address - Country:US
Practice Address - Phone:614-889-0989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty