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Organization

PARTNERS PHYSICIAN GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIMOTHY L LONGVILLE (CHIEF ACCOUNTING OFFICER AND CONTRO)
(216) 636-7416
Entity
Organization

Contact information

Practice address
4125 MEDINA RD, AKRON, OH 44333-2483
(330) 344-1980
Mailing address
4125 MEDINA RD, AKRON, OH 44333-2483

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
OH
207X00000X
Orthopaedic Surgery Physician
Primary
OH
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
OH
207XX0801X
Orthopaedic Trauma Physician
OH
213E00000X
Podiatrist
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1841239274
PARTNERS PHYSICIAN GROUP NPI #
OH
01
2551671
PARTNERS PHYSICIAN GROUP MEDICAID #
OH
01
9338635
PARTNERS PHYSICIAN GROUP MEDICARE #
OH
Enumeration date
06/04/2006
Last updated
02/23/2022
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