Organization
FAMILY PRACTICE CENTER WOOSTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND GREGORY MASON M.D. (PRESIDENT)
(330) 345-2008
Entity
Organization
Contact information
Practice address
128 E MILLTOWN RD, SUITE 205, WOOSTER, OH 44691-6109
(330) 345-2008
(330) 345-0056
Mailing address
128 E MILLTOWN RD STE 205, WOOSTER, OH 44691-1276
(330) 345-2008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35077914M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2211645
—
OH
01
—
CK7409
RAILROAD MEDICARE
—
Enumeration date
03/06/2008
Last updated
05/21/2014
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