Healthcare Provider Details

I. General information

NPI: 1679529614
Provider Name (Legal Business Name): CAROLYN E PENROD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLYN ELIZABETH TOTH

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 09/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4125 MEDINA RD
AKRON OH
44333-2483
US

IV. Provider business mailing address

1 PERKINS SQ
AKRON OH
44308-1063
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-2500
  • Fax: 330-543-2501
Mailing address:
  • Phone: 330-543-2500
  • Fax: 330-543-2501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.085707
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: