MEDICARE: DR. MARTIN J GOTTSCHLING D C

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	111N00000X	Chiropractor	1257	OH

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	341815713003	OTHER	OH	MEDICAL MUTUAL
3	000000139658	OTHER	OH	ANTHEM
4	44-00307	OTHER	OH	UNITED HEALTH CARE

General Provider Information

NPI Number	:	1417966045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN J GOTTSCHLING D C

Provider Business Mailing Address
First Line	:	605 S TRIMBLE RD
Second Line	:	SUITE A
City	:	MANSFIELD
State	:	OH
Zip	:	44906-4112
Country	:	US
Telephone Number	:	419-756-2986
Fax Number	:	419-756-4381

Provider Business Practice Location Address
First Line	:	605 S TRIMBLE RD
Second Line	:	SUITE A
City	:	MANSFIELD
State	:	OH
Zip	:	44906-4112
Country	:	US
Telephone Number	:	419-756-2986
Fax Number	:	419-756-4381

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	10/17/2007

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