Healthcare Provider Details

I. General information

NPI: 1780638080
Provider Name (Legal Business Name): PARAGON HEALTH ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 06/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 BOETTLER RD SUITE 225
UNIONTOWN OH
44685-7792
US

IV. Provider business mailing address

1 PARK WEST BLVD SUITE 200
AKRON OH
44320-4218
US

V. Phone/Fax

Practice location:
  • Phone: 330-899-9696
  • Fax: 330-899-9596
Mailing address:
  • Phone: 330-869-9777
  • Fax: 330-869-0052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. MELANIE L MICK
Title or Position: MEDICAL CREDENTIALING CONSULTANT
Credential:
Phone: 234-855-6458