Basic Information
| Provider Information | |||||||||
| NPI: | 1407801178 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EKG ASSOCIATES II, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 121 W HIGH ST | ||||||||
| Address2: | FIFTH FLOOR | ||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458014340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199984573 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1001 BELLEFONTAINE AVE | ||||||||
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| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458042800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192283335 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2006 | ||||||||
| LastUpdateDate: | 03/07/2008 | ||||||||
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| AuthorizedOfficialLastName: | BAMDAD | ||||||||
| AuthorizedOfficialFirstName: | A. PIERRE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4192245915 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.