Healthcare Provider Details

I. General information

NPI: 1902369978
Provider Name (Legal Business Name): MARK TIMOTHY LOMASNEY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: TIM LOMASNEY DO

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MARKET ST
BOARDMAN OH
44512-6725
US

IV. Provider business mailing address

4362 BAINTREE RD
UNIVERSITY HEIGHTS OH
44118-3931
US

V. Phone/Fax

Practice location:
  • Phone: 330-729-7960
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number58.030969
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: