# LIMA MEMORIAL PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lima Memorial Health System Heart & Vascular Institute, Ohio Cardiothoracic and Vascular Surgeons
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457819450
- **Authorized official:** JEFFREY UTZ (DIRECTOR OF LMP)
- **Authorized official phone:** (419) 998-4668

## Contact information

- **Practice address:** 1003 BELLEFONTAINE AVE STE 200, LIMA, OH 45804-2868
- **Practice address phone:** (419) 227-7702
- **Practice address fax:** (419) 227-7991
- **Mailing address:** 1001 BELLEFONTAINE AVE, LIMA, OH 45804-2800
- **Mailing address phone:** (419) 998-4575
- **Mailing address fax:** (419) 998-4586

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |
| 363AS0400X | Surgical Physician Assistant | — | NULL | — |
| 363AS0400X | Surgical Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 03/08/2019
- **Last updated:** 04/09/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1457474900 | GROUP NPI | OH |
| 05 | — | 2223703 | — | OH |