Healthcare Provider Details

I. General information

NPI: 1124224837
Provider Name (Legal Business Name): WILLIAM J NOVAK JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 11/16/2021
Certification Date: 11/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 CLEVELAND RD
WOOSTER OH
44691-2204
US

IV. Provider business mailing address

1740 CLEVELAND RD
WOOSTER OH
44691-2204
US

V. Phone/Fax

Practice location:
  • Phone: 330-287-4500
  • Fax:
Mailing address:
  • Phone: 330-287-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number35088380
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number35088380
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: