Healthcare Provider Details

I. General information

NPI: 1760452585
Provider Name (Legal Business Name): LOUISVILLE MEDICAL CENTER PHYSICIANS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 10/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 WILLIAMSBURG WAY NE
LOUISVILLE OH
44641-8781
US

IV. Provider business mailing address

1909 WILLIAMSBURG WAY NE
LOUISVILLE OH
44641-8781
US

V. Phone/Fax

Practice location:
  • Phone: 330-875-3366
  • Fax:
Mailing address:
  • Phone: 330-875-3366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TERRENCE L. PANSINO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 330-875-3366