Organization
PROMEDICA CENTRAL PHYSICIANS, LLC
Active
Other names
Wildwood Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
KENYA DIXON (CREDENTIALING ASSISTANT)
(419) 824-7288
Entity
Organization
Contact information
Practice address
2865 N REYNOLDS RD, SUITE 130, TOLEDO, OH 43615-2068
(419) 578-7036
(419) 537-5597
Mailing address
2865 N REYNOLDS RD, SUITE 130, TOLEDO, OH 43615-2068
(419) 578-7036
(419) 537-5597
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
02/17/2007
Last updated
02/18/2008
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