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General NPI Number Information
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NPI Number | 1154345577
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Entity Type | Organization
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Legal Business Name | MERCY HEALTH - WILLARD HOSPITAL LLC
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 09/02/2014
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Provider Practice Location Address
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Address Line | 110 EAST HOWARD ST
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City | WILLARD
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State | OH
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Zip | 44890-1611
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Country | US
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Telephone | 419-694-5020
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 JEFFERSON AVE 4TH FLOOR
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City | TOLEDO
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State | OH
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Zip | 43624-1120
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Country | US
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Telephone | 419-251-8983
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Fax |
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Authorized Official
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Title or Position | EVP
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Name | MR. BRIAN D SMITH
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Credential |
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Telephone | 419-226-9117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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