Charles P House Sr DO

Organization Active NPI Family Medicine Physician · Clyde, OH

NPI 1497724140 · NPPES record last updated Feb 23, 2015

Key facts

NPI
1497724140
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
CHARLES P HOUSE SR DO
Practice address
700 W Maple St
Clyde, OH 43410-1414
Phone
(419) 547-0584
Fax
(419) 547-8918
NPI assigned
Mar 15, 2006
Organization subpart
No

Authorized official

Name
Dr. Charles P House Sr., DO
Title
President
Phone
(419) 547-0584

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Charles P House Sr DO (2 organizations share this tax ID)

Locations

700 W Maple St
Clyde, OH 43410
Phone (419) 547-0584

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

700 W Maple St
Clyde, OH 43410-1414

Mailing address

PO Box 179
Bellevue, OH 44811-0179
Phone (440) 274-5035

Other identifiers

IdentifierTypeStateIssuer
603819300OtherOHDEPT OF LABOR
DC6183OtherOHRAILROAD MEDICARE

Other providers in Clyde, OH

All providers in Clyde, OH · Family Medicine Physician in Ohio

Sources for this page

Verify at the official NPI Registry.