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Contact Information

GENESIS MEDICAL GROUP LLC
712 CHINA STREET
CROOKSVILLE FAMILY CLINIC INC.
CROOKSVILLE, OH43731-1124
 Phone: 740-982-6872
 Fax: 740-982-5551
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
 

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
 

Rural Health

261QR1300X B4[14] Rural Health Clinic
Indicates primary specialty

NPI Profile & details for GENESIS MEDICAL GROUP LLC · (Female)

NPI Number 1437218526
Status Active
Credentials
Entity Individual
Enumeration date 12/06/2006
Last updated 12/17/2013 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers
  • OH Medicaid 2270313
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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