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Individual

JEFFREY DONN LODGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
340 S BROADWAY ST, AKRON, OH 44308-1529
(330) 253-3100
(330) 253-5248
Mailing address
340 S BROADWAY ST, AKRON, OH 44308-1529
(330) 253-3100
(330) 253-5248

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
35.089921
OH
2084P0800X
Psychiatry Physician
Primary
35089921
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2314561
OH
Enumeration date
07/12/2007
Last updated
03/30/2009
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