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NPI Code Detail

MEDICARE: MR. MICHAEL FRANCIS TATKO PA-C

MEDICARE: MR. MICHAEL FRANCIS TATKO PA-C
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
1363A00000XPhysician AssistantMA001555LPA
2363A00000XPhysician Assistant50.005998RXOH

General Provider Information

NPI Number : 1528067246
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL FRANCIS TATKO PA-C
Provider Business Mailing Address
First Line : 9471 MARKET ST STE A
Second Line :
City : NORTH LIMA
State : OH
Zip : 44452-8702
Country : US
Telephone Number : 330-726-7100
Fax Number : 330-758-0347
Provider Business Practice Location Address
First Line : 9471 MARKET ST STE A
Second Line :
City : NORTH LIMA
State : OH
Zip : 44452-8702
Country : US
Telephone Number : 330-726-7100
Fax Number : 330-758-0347
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 09/10/2019

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Directions to “ MR. MICHAEL FRANCIS TATKO PA-C” Practice Location

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