Organization
M & K FAMILY AND SPORTS MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA A MANSFIELD M.D. (PRESIDENT)
(419) 538-7330
Entity
Organization
Contact information
Practice address
601 US 224, GLANDORF, OH 45848
(419) 538-7330
(419) 538-7331
Mailing address
PO BOX 81, GLANDORF, OH 45848-0081
(419) 538-7330
(419) 538-7331
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2986729
—
OH
01
—
DF2023
MEDICARE RAILROAD GROUP
—
Enumeration date
09/27/2006
Last updated
11/23/2009
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