Healthcare Provider Details

I. General information

NPI: 1447651237
Provider Name (Legal Business Name): PARTNERS PHYSICIAN GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2014
Last Update Date: 07/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1946 TOWN PARK BLVD 'SHARED SUITE'
UNIONTOWN OH
44685-8372
US

IV. Provider business mailing address

1946 TOWN PARK BLVD 'SHARED SUITE'
UNIONTOWN OH
44685-8372
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-5487
  • Fax: 330-344-2025
Mailing address:
  • Phone: 330-344-5487
  • Fax: 330-344-2025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateOH
# 6
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: KENNETH BRAMAN
Title or Position: CHIEF MEDICAL OFFICER
Credential: DO
Phone: 330-665-8302