Healthcare Provider Details

I. General information

NPI: 1851328272
Provider Name (Legal Business Name): WILLIAM FREDRICK OEHLENSCHLAGER M.D./PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 09/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 HIGH ST
WADSWORTH OH
44281-9421
US

IV. Provider business mailing address

143 VALLEY VIEW DR
WADSWORTH OH
44281-1650
US

V. Phone/Fax

Practice location:
  • Phone: 330-335-7337
  • Fax: 330-334-8309
Mailing address:
  • Phone: 330-730-0329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35067816
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: