Healthcare Provider Details

I. General information

NPI: 1841562238
Provider Name (Legal Business Name): PARTNERS PHYSICIAN GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2012
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 W EXCHANGE ST #240
AKRON OH
44302-1704
US

IV. Provider business mailing address

224 W EXCHANGE ST #240
AKRON OH
44302-1704
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-1687
  • Fax: 330-344-2128
Mailing address:
  • Phone: 330-344-1687
  • Fax: 330-344-2128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: DANIEL TAILLARD
Title or Position: DIRECTOR, FINANCE & OPERATIONS
Credential:
Phone: 330-344-6095