Organization
CITY OF DEFIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN WITTKOP (CHIEF)
(419) 783-4374
Entity
Organization
Contact information
Practice address
702 W 3RD ST, DEFIANCE, OH 43512-2108
(419) 782-2771
Mailing address
PO BOX 547, WHEELING, IL 60090-0547
(419) 782-2771
(336) 791-0196
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000156054
ANTHEM
OH
05
—
0605134
—
OH
01
—
590006859
RAILROAD MEDICARE
OH
Enumeration date
06/25/2006
Last updated
03/05/2026
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