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
1946 TOWN PARK BLVD, UNIONTOWN, OH 44685-7855
(330) 896-3447
Mailing address
1946 TOWN PARK BLVD, UNIONTOWN, OH 44685-7855
(330) 896-3447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
OH
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208800000X
Urology Physician
—
—
213E00000X
Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH
01
—
2551671
PARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH
01
—
9338635
PARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH
Enumeration date
06/04/2006
Last updated
02/23/2022
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