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Organization

PARTNERS PHYSICIAN GROUP

Active
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Organization

PARTNERS PHYSICIAN GROUP

Active
Other names
Bath Medical Group
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL TAILLARD (DIRECTOR, FINANCE & OPERATIONS)
(330) 344-6095
Entity
Organization

Contact information

Practice address
4125 MEDINA RD, #215, AKRON, OH 44333-2483
(330) 665-8143
(330) 668-1289
Mailing address
4125 MEDINA RD, #215, AKRON, OH 44333-2483
(330) 665-8143
(330) 668-1289

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34-006963
OH
207VG0400X
Gynecology Physician
35-050322
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH
01
—
2551671
PARTNERS PHYSICIAN GROUP MEDICAID #
OH
01
—
9338635
PARTNERS PHYSICIAN GROUP MEDICARE #
OH
Enumeration date
05/24/2011
Last updated
07/01/2011
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