Healthcare Provider Details

I. General information

NPI: 1427314012
Provider Name (Legal Business Name): JASON ERIC THUENER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1932 NILES CORTLAND RD NE STE B
WARREN OH
44484-1055
US

IV. Provider business mailing address

1932 NILES CORTLAND RD NE STE B
WARREN OH
44484-1055
US

V. Phone/Fax

Practice location:
  • Phone: 330-729-3195
  • Fax: 330-856-2530
Mailing address:
  • Phone: 330-729-3195
  • Fax: 330-856-2530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number35.131562
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: