MEDICARE: WEST PARK FAMILY 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	207Q00000X	Family Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CH5592	OTHER	OH	RAILROAD MEDICARE

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

General Provider Information

NPI Number	:	1639139199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST PARK FAMILY PHYSICIANS, INC.

Provider Business Mailing Address
First Line	:	4041 W SYLVANIA AVE
Second Line	:	SUITE 100
City	:	TOLEDO
State	:	OH
Zip	:	43623-4465
Country	:	US
Telephone Number	:	419-472-1124
Fax Number	:	419-486-8857

Provider Business Practice Location Address
First Line	:	4041 W SYLVANIA AVE
Second Line	:	SUITE 100
City	:	TOLEDO
State	:	OH
Zip	:	43623-4465
Country	:	US
Telephone Number	:	419-472-1124
Fax Number	:	419-486-8857

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARK D HILLARD
Credential	:	M.D.
Telephone Number	:	419-472-1124

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	11/06/2009

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Directions to “WEST PARK FAMILY PHYSICIANS, INC. ” Practice Location

Language	Start Address	Practice Location

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