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Organization

TUSC COUNTY MEDICAL SPECIALTIES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BLAIR THOMAS HOLDER M.D. (M.D.)
(330) 364-4600
Entity
Organization

Contact information

Practice address
300 MEDICAL PARK DR, SUITE 205, DOVER, OH 44622-2073
(330) 364-4600
(330) 364-3338
Mailing address
300 MEDICAL PARK DR, SUITE 205, DOVER, OH 44622-2073
(330) 364-4600
(330) 364-3338

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
55408
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110192418
RAILROAD MEDICARE
OH
05
2102101
OH
Enumeration date
10/22/2007
Last updated
01/06/2020
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