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General NPI Number Information
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NPI Number | 1376819482
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Entity Type | Organization
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Legal Business Name | 1227 EAST MARKET STREET, INC.
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Dates
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Enumeration Date | 03/23/2012
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Last Update Date | 03/23/2012
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Provider Practice Location Address
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Address Line | 1227 E MARKET ST
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City | WARREN
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State | OH
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Zip | 44483-6605
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Country | US
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Telephone | 330-393-1501
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Fax | 330-394-4539
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Provider Business Mailing Address
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Address Line | 1227 E MARKET ST
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City | WARREN
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State | OH
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Zip | 44483-6605
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Country | US
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Telephone | 330-393-1501
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Fax | 330-394-4539
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KATHLEEN DILLON
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Credential |
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Telephone | 330-393-1501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 209800000X
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Taxonomy Name | Legal Medicine (M.D./D.O.) Physician
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License Number |
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License Number State |
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