Organization
PAULDING MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FREDERIC CHARLES HENDRICKSON D.O. (OWNER)
(419) 399-2630
Entity
Organization
Contact information
Practice address
11550 STATE ROUTE 500, PAULDING, OH 45879-9173
(419) 399-2630
(419) 399-3039
Mailing address
11550 STATE ROUTE 500, PAULDING, OH 45879-9173
(419) 399-2630
(419) 399-3039
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
34-005455
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0853170
—
OH
Enumeration date
06/21/2010
Last updated
06/21/2010
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