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General NPI Number Information
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NPI Number | 1225384449
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Entity Type | Individual
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Provider Name | JASON EDWARD WARTGOW CNP
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Gender | Male
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 05/27/2014
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Provider Practice Location Address
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Address Line | 1900 S MAIN ST
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City | FINDLAY
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State | OH
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Zip | 45840-1214
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Country | US
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Telephone | 419-423-5500
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Fax | 419-423-5538
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Provider Business Mailing Address
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Address Line | 7550 LUCERNE DR SUITE 405
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City | CLEVELAND
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State | OH
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Zip | 44130-6588
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Country | US
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Telephone | 440-234-8833
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Fax | 440-234-3313
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | COA.13583-NP
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License Number State | OH
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