MEDICARE: PARTNERS PHYSICIAN GROUP

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	2088F0040X	Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician		OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9338635	OTHER	OH	PARTNERS PHYSICIAN GROUP MEDICARE GROUP #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1841239274	OTHER	OH	PARTNERS PHYSICIAN GROUP TYPE 2 NPI #

General Provider Information

NPI Number	:	1487096277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARTNERS PHYSICIAN GROUP

Provider Business Mailing Address
First Line	:	2603 W MARKET ST
Second Line	:	#210
City	:	AKRON
State	:	OH
Zip	:	44313-4208
Country	:	US
Telephone Number	:	330-344-1382
Fax Number	:

Provider Business Practice Location Address
First Line	:	2603 W MARKET ST
Second Line	:	#210
City	:	AKRON
State	:	OH
Zip	:	44313-4208
Country	:	US
Telephone Number	:	330-344-1382
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR FINANCE REVENUE CYCLE, PPG
Name	:	JEFFREY KOVACS
Credential	:
Telephone Number	:	330-665-8332

Provider Enumeration Date	:	07/23/2013
Last Update Date	:	07/23/2013

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Directions to “PARTNERS PHYSICIAN GROUP ” Practice Location

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