Healthcare Provider Details

I. General information

NPI: 1336356047
Provider Name (Legal Business Name): PARTNERS PHYSICIAN GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 WABASH AVE
AKRON OH
44307-2433
US

IV. Provider business mailing address

3428 W MARKET ST #103
FAIRLAWN OH
44333-3339
US

V. Phone/Fax

Practice location:
  • Phone: 330-665-8221
  • Fax: 330-665-8321
Mailing address:
  • Phone: 330-344-3583
  • Fax: 330-869-2074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: THOMAS M LUBOTSKY
Title or Position: PRESIDENT, AKRON GENERAL PARTNERS
Credential:
Phone: 330-665-8218