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NPI Code Detail

MEDICARE: RICHLAND FAMILY PRACTICE, LTD

MEDICARE: RICHLAND FAMILY PRACTICE, LTD
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1922159524
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICHLAND FAMILY PRACTICE, LTD
Provider Business Mailing Address
First Line : 680 PARK AVE W
Second Line : SUITE 204
City : MANSFIELD
State : OH
Zip : 44906-3706
Country : US
Telephone Number : 419-524-1410
Fax Number : 419-524-2202
Provider Business Practice Location Address
First Line : 680 PARK AVE W
Second Line : SUITE 204
City : MANSFIELD
State : OH
Zip : 44906-3706
Country : US
Telephone Number : 419-524-1410
Fax Number : 419-524-2202
Authorized Official
Title or Position : PRESIDENT
Name : MR. DANIEL D BURWELL
Credential : D.O.
Telephone Number : 419-524-1410
Provider Enumeration Date : 01/12/2007
Last Update Date : 04/22/2008

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Directions to “RICHLAND FAMILY PRACTICE, LTD ” Practice Location

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