Provider Demographics
NPI:1447294277
Name:DOCTORS URGENT CARE OFFICES MEDICAL GROUP INC
Entity type:Organization
Organization Name:DOCTORS URGENT CARE OFFICES MEDICAL GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:AMRHEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-831-5955
Mailing Address - Street 1:935 STATE ROUTE 28
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1911
Mailing Address - Country:US
Mailing Address - Phone:513-831-5955
Mailing Address - Fax:513-831-5985
Practice Address - Street 1:650 SPRUCEWOOD LN
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-1062
Practice Address - Country:US
Practice Address - Phone:859-282-6600
Practice Address - Fax:859-282-8817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X, 363A00000X, 363L00000X
N/A261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY18D1014578OtherCLIA WAIVER
KY7938Medicare PIN