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General NPI Number Information
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NPI Number | 1679534077
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Entity Type | Organization
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Legal Business Name | MANSFIELD ORTHOPAEDIC SURGERY & RHEUMATOLOGY INC
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 06/08/2009
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Provider Practice Location Address
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Address Line | 536 S TRIMBLE RD
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City | MANSFIELD
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State | OH
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Zip | 44906
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Country | US
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Telephone | 419-756-8899
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Fax | 419-756-6004
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Provider Business Mailing Address
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Address Line | 536 S TRIMBLE RD
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City | MANSFIELD
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State | OH
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Zip | 44906
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Country | US
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Telephone | 419-756-8899
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Fax | 419-756-6004
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAWRENCE L GIBSON
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Credential | MD
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Telephone | 419-756-8899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology 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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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