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Organization
WAUSEON FAMILY PRACTICE
Active
Organization
WAUSEON FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMON ANTHONY ISSA M.D. (OWNER)
(419) 337-9990
Entity
Organization
Contact information
Practice address
725 S SHOOP AVE, WAUSEON, OH 43567-1702
(419) 337-9990
(419) 337-9996
Mailing address
725 S SHOOP AVE, WAUSEON, OH 43567-1702
(419) 337-9990
(419) 337-9996
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35083971
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000350389
ANTHEM
—
05
—
2504669
—
OH
Enumeration date
11/20/2007
Last updated
04/20/2008
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