Healthcare Provider Details

I. General information

NPI: 1255613840
Provider Name (Legal Business Name): TWIN SPRINGS MEDICAL CENTER LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2011
Last Update Date: 03/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12991 EMERSON RD
APPLE CREEK OH
44606-9302
US

IV. Provider business mailing address

12991 EMERSON RD PO BOX 247 KIDRON OH 44636
APPLE CREEK OH
44606-9302
US

V. Phone/Fax

Practice location:
  • Phone: 330-857-0177
  • Fax: 330-857-0190
Mailing address:
  • Phone: 330-857-0177
  • Fax: 330-857-0190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.010303
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34-00-5514
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCOA.05334.NM
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCOA.14487.NM
License Number StateOH

VIII. Authorized Official

Name: MRS. CAREY ANN CAMPBELL
Title or Position: OFFICE COORDINATOR
Credential:
Phone: 330-857-0177