Healthcare Provider Details

I. General information

NPI: 1710036231
Provider Name (Legal Business Name): PATRICIA LOHR GOETZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

832 MCKINLEY AVE NW
CANTON OH
44703-2463
US

IV. Provider business mailing address

8 PITKIN DR
HUDSON OH
44236-2263
US

V. Phone/Fax

Practice location:
  • Phone: 330-452-9812
  • Fax: 330-430-1288
Mailing address:
  • Phone: 330-452-9812
  • Fax: 330-430-1288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35-056415
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number35-056415
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: