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General NPI Number Information
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NPI Number | 1770779720
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Entity Type | Organization
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Legal Business Name | WESTBROOK OB/GYN, INC.
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Dates
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Enumeration Date | 09/23/2007
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 2525 13TH ST NW
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City | CANTON
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State | OH
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Zip | 44708-3118
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Country | US
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Telephone | 330-455-5231
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Fax | 330-455-1403
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Provider Business Mailing Address
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Address Line | 2525 13TH ST NW
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City | CANTON
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State | OH
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Zip | 44708-3118
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Country | US
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Telephone | 330-455-5231
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Fax | 330-455-1403
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Authorized Official
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Title or Position | PHYSICIAN
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Name | VICTOR HIRAM BAZZOLI
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Credential | M.D.
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Telephone | 330-455-5231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | OH
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