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General NPI Number Information
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NPI Number | 1114944600
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Entity Type | Individual
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Provider Name | JULIE LYNN OBERLY MD
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 02/06/2008
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Provider Practice Location Address
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Address Line | 1401 SOUTH MAIN STREET SUITE 101
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City | NORTH CANTON
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State | OH
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Zip | 44720
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Country | US
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Telephone | 330-497-8636
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Fax | 330-497-8634
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Provider Business Mailing Address
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Address Line | 3111 LOTZ AVE SE
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City | EAST CANTON
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State | OH
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Zip | 44730-9727
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Country | US
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Telephone | 330-488-5404
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Fax | 330-488-3047
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35076929O
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License Number State | OH
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