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General NPI Number Information
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NPI Number | 1497755623
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Entity Type | Organization
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Legal Business Name | GENESIS PROFESSIONAL CORP
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 800 FOREST AVE
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City | ZANESVILLE
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State | OH
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Zip | 43701-2882
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Country | US
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Telephone | 740-454-0366
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Fax | 740-454-3790
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Provider Business Mailing Address
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Address Line | PO BOX 790
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City | ZANESVILLE
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State | OH
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Zip | 43702-0790
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Country | US
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Telephone | 740-454-0366
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Fax | 740-454-3790
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Authorized Official
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Title or Position | PRESIDENT
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Name | AL BURNS
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Credential |
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Telephone | 740-454-0366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) 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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease 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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease 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 | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #9
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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 #10
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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