Healthcare Provider Details

I. General information

NPI: 1548132749
Provider Name (Legal Business Name): PERKOWSKI FAMILY MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 E SHAFER AVE
DOVER OH
44622-2053
US

IV. Provider business mailing address

715 E SHAFER AVE
DOVER OH
44622-2053
US

V. Phone/Fax

Practice location:
  • Phone: 330-204-9498
  • Fax:
Mailing address:
  • Phone: 330-556-0440
  • Fax: 330-556-0441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CASEY THOMAS PERKOWSKI
Title or Position: PHYSCIAN/OWNER
Credential: MD
Phone: 330-204-9498