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General NPI Number Information
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NPI Number | 1487626628
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Entity Type | Organization
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Legal Business Name | PERRY EAR NOSE AND THROAT CLINIC
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 12/10/2007
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Provider Practice Location Address
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Address Line | 3545 LINCOLN WAY E
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City | MASSILLON
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State | OH
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Zip | 44646
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Country | US
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Telephone | 330-837-3559
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Fax | 330-837-3052
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Provider Business Mailing Address
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Address Line | 3545 LINCOLN WAY E
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City | MASSILLON
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State | OH
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Zip | 44646
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Country | US
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Telephone | 330-837-3559
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Fax | 330-837-3052
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGE W VOGELGESANG
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Credential | DO FOCOO
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Telephone | 330-837-3359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 34001983V
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License Number State | OH
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