MEDICARE: SOUTHWEST GENERAL MEDICAL GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144414871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST GENERAL MEDICAL GROUP, INC.

Provider Business Mailing Address
First Line	:	PO BOX 638269
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-0001
Country	:	US
Telephone Number	:	440-816-5390
Fax Number	:	440-816-6438

Provider Business Practice Location Address
First Line	:	15900 SNOW RD
Second Line	:
City	:	BROOK PARK
State	:	OH
Zip	:	44142-2859
Country	:	US
Telephone Number	:	216-676-1234
Fax Number	:	440-816-6438

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	HEATHER WAGNER
Credential	:
Telephone Number	:	440-816-4906

Provider Enumeration Date	:	09/06/2007
Last Update Date	:	02/28/2019

Similar Medicare Providers

1932133295 — JULIE MYERS PT
Practice Location Address:

15900 SNOW RD
BROOK PARK, OH
44142-2859

Practice Phone: 216-265-3454
Practice Fax: 216-267-5553

1902818586 — LISA R JEWETT PT
Practice Location Address:

15900 SNOW RD
BROOK PARK, OH
44142-2859

Practice Phone: 216-265-3454
Practice Fax: 216-267-5553

1790873131 — HORIZON ORTHOPEDIC, INC
Practice Location Address:

15900 SNOW RD
BROOK PARK, OH
44142-2859

Practice Phone: 216-676-1234
Practice Fax:

1467640201 — MARY E STUPCZY PT
Practice Location Address:

15900 SNOW RD
BROOK PARK, OH
44142-2859

Practice Phone: 216-896-0824
Practice Fax: 216-896-0825

1558427310 — DR. ANGELA LYNN MANNING D.D.S
Practice Location Address:

555 WESTCHESTER AVE
RYE BROOK, NY
10573-2859

Practice Phone: 914-305-6555
Practice Fax:

1588641021 — JESSICA MCCLELLAN PT
Practice Location Address:

15900 SNOW RD
BROOKPARK, OH
44142-2859

Practice Phone: 216-265-3454
Practice Fax: 216-267-5553

Directions to “SOUTHWEST GENERAL MEDICAL GROUP, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.