Organization
KIDZ FIRST PEDIATRICS OF OBERLIN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN R SANDERSON D.O. (PRESIDENT)
(440) 775-1555
Entity
Organization
Contact information
Practice address
12289 LEAVITT RD, UNIT D, OBERLIN, OH 44074-8500
(440) 775-1555
Mailing address
12289 LEAVITT RD, UNIT D, OBERLIN, OH 44074-8500
(440) 775-1555
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
34.006510
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457449035
INDIVIDUAL NPI
—
Enumeration date
10/31/2007
Last updated
10/31/2007
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