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General NPI Number Information
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NPI Number | 1861798084
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Entity Type | Individual
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Provider Name | JESSICA L TOLAND PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 16761 SOUTHPARK CTR
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City | STRONGSVILLE
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State | OH
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Zip | 44136
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Country | US
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Telephone | 440-878-2500
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Fax | 440-878-3074
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Provider Business Mailing Address
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Address Line | 16761 SOUTHPARK CTR
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City | STRONGSVILLE
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State | OH
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Zip | 44136-9302
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Country | US
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Telephone | 440-878-2500
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Fax | 440-878-3074
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 50.003218
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 50.003218
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License Number State | OH
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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 | 50.003218
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License Number State | OH
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