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Organization
PROMEDICA CENTRAL PHYSICIANS, LLC
Active
Organization
PROMEDICA CENTRAL PHYSICIANS, LLC
Active
Other names
Wildwood Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
KENYA DIXON (CREDENTIALING ASSISTANT)
(419) 824-7288
Entity
Organization
Contact information
Practice address
2865 N REYNOLDS RD, SUITE 130, TOLEDO, OH 43615-2068
(419) 578-7036
(419) 537-5597
Mailing address
2865 N REYNOLDS RD, SUITE 130, TOLEDO, OH 43615-2068
(419) 578-7036
(419) 537-5597
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
02/17/2007
Last updated
02/18/2008
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