Organization
PARTNERS PHYSICIAN GROUP
Active
Other names
Northeast Ohio Orthopaedic Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL TAILLARD (VP, FINANCE)
(330) 344-6095
Entity
Organization
Contact information
Practice address
754 S CLEVELAND AVE, #301, MOGADORE, OH 44260-2210
(330) 344-1980
(330) 344-6038
Mailing address
754 S CLEVELAND AVE, #301, MOGADORE, OH 44260-2210
(330) 344-1980
(330) 344-6038
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
OH
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
—
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
04/17/2012
Last updated
04/17/2012
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