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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

NPI # 1437218526
LBN Legal business name GENESIS MEDICAL GROUP LLC
Authorized official PAUL MASTERSON - (ASSIST, TREASURER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/06/2006
Last updated 12/17/2013 - About 12 years ago
Identifiers
OH Medicaid 2270313
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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