Organization
PHYSICIANS PROVIDER SERVICES,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW JIMERSON M.D. (PHYSICIAN)
(216) 921-5222
Entity
Organization
Contact information
Practice address
16603 HARVARD AVE, CLEVELAND, OH 44128-2203
(216) 921-5222
(216) 921-6421
Mailing address
16603 HARVARD AVE, CLEVELAND, OH 44128-2203
(216) 921-5222
(216) 921-6421
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
35041190J
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0414439
—
OH
05
—
2183622
—
OH
Enumeration date
01/28/2008
Last updated
09/26/2008
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