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Organization
PARTNERS PHYSICIAN GROUP
Active
Organization
PARTNERS PHYSICIAN GROUP
Active
Other names
Akron General Portage Hills Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL TAILLARD (DIRECTOR, FINANCE)
(330) 344-6095
Entity
Organization
Contact information
Practice address
754 S CLEVELAND AVE, MOGADORE, OH 44260-2210
(330) 628-2686
(330) 628-0828
Mailing address
754 S CLEVELAND AVE, MOGADORE, OH 44260-2210
(330) 628-2686
(330) 628-0828
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841239274
MEDICARE GROUP NPI #
OH
01
—
2551671
MEDICAID GROUP #
OH
01
—
9338635
MEDICARE GROUP #
OH
Enumeration date
09/25/2008
Last updated
07/01/2011
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