Healthcare Provider Details

I. General information

NPI: 1144538166
Provider Name (Legal Business Name): PARTNERS PHYSICIAN GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2010
Last Update Date: 09/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 W EXCHANGE ST #220
AKRON OH
44302-1704
US

IV. Provider business mailing address

224 W EXCHANGE ST #220
AKRON OH
44302-1704
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-7759
  • Fax: 330-996-2498
Mailing address:
  • Phone: 330-344-7759
  • Fax: 330-996-2498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: LOUANN CRAWFORD
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 330-344-3583