Healthcare Provider Details

I. General information

NPI: 1205822871
Provider Name (Legal Business Name): R. TODD STRICKLAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 10/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1323 E MANSFIELD ST
BUCYRUS OH
44820-1960
US

IV. Provider business mailing address

1323 E MANSFIELD ST
BUCYRUS OH
44820-1960
US

V. Phone/Fax

Practice location:
  • Phone: 419-563-0300
  • Fax: 419-563-0500
Mailing address:
  • Phone: 419-563-0300
  • Fax: 419-562-2098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35068424S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: