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General NPI Number Information
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NPI Number | 1962501627
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Entity Type | Organization
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Legal Business Name | BLANCHARD VALLEY MEDICAL PRACTICE LLC
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 1900 SOUTH MAIN STREET
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City | FINDLAY
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State | OH
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Zip | 45840-1239
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Country | US
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Telephone | 419-423-4500
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Fax | 419-423-5550
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Provider Business Mailing Address
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Address Line | 1900 S MAIN ST
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City | FINDLAY
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State | OH
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Zip | 45840-1214
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Country | US
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Telephone | 419-423-4500
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Fax | 419-423-5550
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Authorized Official
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Title or Position | VP
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Name | DAVID CYTLAK
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Credential |
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Telephone | 41944235497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease 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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 35088792
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #8
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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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