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General NPI Number Information
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NPI Number | 1588801245
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Entity Type | Organization
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Legal Business Name | UTP PATHOLOGY SERVICES LLC
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Dates
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Enumeration Date | 01/16/2009
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 3000 ARLINGTON AVE
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City | TOLEDO
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State | OH
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Zip | 43614-2595
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Country | US
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Telephone | 419-383-3470
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Fax |
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Provider Business Mailing Address
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Address Line | 3355 GLENDALE AVE THIRD FLOOR
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City | TOLEDO
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State | OH
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Zip | 43614-2426
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Country | US
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Telephone | 419-383-7100
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Fax | 419-383-2000
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. GERARD OTTEN
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Credential |
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Telephone | 419-383-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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