Healthcare Provider Details

I. General information

NPI: 1437295953
Provider Name (Legal Business Name): MINE O. OZKAZANC, MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 03/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5319 HOAG DRIVE 230
ELYRIA OH
44035
US

IV. Provider business mailing address

5319 HOAG DRIVE 230
ELYRIA OH
44035
US

V. Phone/Fax

Practice location:
  • Phone: 440-930-6016
  • Fax: 440-930-6085
Mailing address:
  • Phone: 440-930-6016
  • Fax: 440-930-6085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35072810O
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: DR. MINE O OZKAZANC
Title or Position: PRESIDENT
Credential: M.D.
Phone: 440-930-6016