Healthcare Provider Details

I. General information

NPI: 1851227557
Provider Name (Legal Business Name): MRMD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 E MILLTOWN RD STE 105
WOOSTER OH
44691-1276
US

IV. Provider business mailing address

128 E MILLTOWN RD STE 105
WOOSTER OH
44691-1276
US

V. Phone/Fax

Practice location:
  • Phone: 330-345-8060
  • Fax:
Mailing address:
  • Phone: 330-345-8060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN PARKER BALLENTINE
Title or Position: OWNER
Credential: MD
Phone: 615-513-5606