MEDICARE: MR. WILLIAM KEVIN LONSDORF MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35040851L	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	9338635	OTHER	OH	PARTNERS PHYSICIAN GROUP MEDICARE GROUP #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1841239274	OTHER	OH	PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013996925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM KEVIN LONSDORF MD

Provider Business Mailing Address
First Line	:	2818 S ARLINGTON RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312
Country	:	US
Telephone Number	:	330-645-0148
Fax Number	:	330-645-1524

Provider Business Practice Location Address
First Line	:	2818 S ARLINGTON RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312
Country	:	US
Telephone Number	:	330-645-0148
Fax Number	:	330-645-1524

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	01/14/2016

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