Healthcare Provider Details

I. General information

NPI: 1487096277
Provider Name (Legal Business Name): PARTNERS PHYSICIAN GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 W MARKET ST #210
AKRON OH
44313-4208
US

IV. Provider business mailing address

2603 W MARKET ST #210
AKRON OH
44313-4208
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-1382
  • Fax:
Mailing address:
  • Phone: 330-344-1382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: JEFFREY KOVACS
Title or Position: DIRECTOR FINANCE REVENUE CYCLE, PPG
Credential:
Phone: 330-665-8332