Healthcare Provider Details

I. General information

NPI: 1669581799
Provider Name (Legal Business Name): JOHN T GIVEN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 04/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4048 DRESSLER RD NW SUITE 100
CANTON OH
44718-2784
US

IV. Provider business mailing address

4048 DRESSLER RD NW SUITE 100
CANTON OH
44718-2784
US

V. Phone/Fax

Practice location:
  • Phone: 330-479-3333
  • Fax: 330-479-3334
Mailing address:
  • Phone: 330-479-3333
  • Fax: 330-479-3334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number35050329
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35050329
License Number StateOH

VIII. Authorized Official

Name: MRS. DEBBIE GIVEN
Title or Position: ADMINISTRATOR
Credential:
Phone: 330-479-3333