Organization
JOHN D VANCE MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN VANCE MD (OWNER)
(330) 856-9797
Entity
Organization
Contact information
Practice address
735 NILES CORTLAND RD SE, WARREN, OH 44484-2475
(330) 856-9797
(330) 856-9684
Mailing address
1988 QUAIL RUN DR, CORTLAND, OH 44410-1803
(330) 637-2882
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35050152
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0849087
—
OH
01
—
DN4013
RAILROAD MEDICARE
OH
Enumeration date
11/15/2007
Last updated
11/13/2008
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