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General NPI Number Information
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NPI Number | 1508168253
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Entity Type | Organization
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Legal Business Name | HOSPITAL MEDICINE ASSOCIATES OF OHIO PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 12/01/2010
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 272 BENEDICT AVE
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City | NORWALK
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State | OH
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Zip | 44857-2374
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Country | US
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Telephone | 419-668-8101
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Fax |
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Provider Business Mailing Address
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Address Line | 14050 NW 14TH ST SUITE 190
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City | SUNRISE
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State | FL
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Zip | 33323-2865
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Country | US
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Telephone | 800-424-3672
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Fax | 954-377-3042
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAURA LYNN DOLLISON
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Credential | MD
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Telephone | 800-424-3672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine 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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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