MEDICARE: CHILDREN'S PHYSICIANS, INC

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	208000000X	Pediatrics Physician		OH

General Provider Information

NPI Number	:	1417038134
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN'S PHYSICIANS, INC

Provider Business Mailing Address
First Line	:	4575 EVERHARD RD NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44718-2406
Country	:	US
Telephone Number	:	330-494-1426
Fax Number	:	330-966-1644

Provider Business Practice Location Address
First Line	:	4575 EVERHARD RD NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44718-2406
Country	:	US
Telephone Number	:	330-494-1426
Fax Number	:	330-966-1644

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. KAREN M CASSLER
Credential	:
Telephone Number	:	330-494-1426

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	07/11/2007

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