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General NPI Number Information
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NPI Number | 1497493829
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Entity Type | Individual
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Provider Name | REBECCA LYNN RADABAUGH PA
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Gender | Female
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Dates
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Enumeration Date | 05/25/2022
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Last Update Date | 09/23/2022
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Provider Practice Location Address
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Address Line | 3557 EMBASSY PKWY
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City | AKRON
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State | OH
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Zip | 44333-8358
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Country | US
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Telephone | 330-670-4242
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Fax | 330-670-4241
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Provider Business Mailing Address
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Address Line | 9611 HESS MILL RD NE
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City | BOLIVAR
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State | OH
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Zip | 44612-8714
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Country | US
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Telephone | 330-663-6110
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.007750RX
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License Number State | OH
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