MEDICARE: JOANN M GOTTSCHLING

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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	371493170002	OTHER	OH	MEDICAL MUTUAL
2	000000340708	OTHER	OH	BLUE CROSS BLUE SHIELD
3	8297165	OTHER	OH	UNITED HEALTH CARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	82010	OTHER	OH	NORTHWOOD NPN

General Provider Information

NPI Number	:	1124184361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANN M GOTTSCHLING

Provider Business Mailing Address
First Line	:	605 S TRIMBLE RD STE A
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44906-4112
Country	:	US
Telephone Number	:	419-756-0766
Fax Number	:	419-756-4381

Provider Business Practice Location Address
First Line	:	605 S TRIMBLE RD STE A
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44906-4112
Country	:	US
Telephone Number	:	419-756-0766
Fax Number	:	419-756-4381

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

Provider Enumeration Date	:	12/30/2006
Last Update Date	:	02/09/2008

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Directions to “ JOANN M GOTTSCHLING ” Practice Location

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