MID OHIO EMERGENCY PHYSICIANS LLP - NPI NUMBER 1548490790

Summary

Provider Name: MID OHIO EMERGENCY PHYSICIANS LLP

NPI Number: 1548490790

Clasification: Emergency Medicine (207P00000X)

Address:
335 GLESSNER AVE
MANSFIELD, OH
ZIP 44903

Phone Number: (419) 526-8000



Detailed Information

MID OHIO EMERGENCY PHYSICIANS LLP is an emergency physician in Mansfield, OH. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. The assigned NPI number for this provider is 1548490790 and is registered as an organization entity type and is a multi-specialty group.

The provider's business address is:

335 GLESSNER AVE
MANSFIELD, OH
ZIP 44903-269
Phone: (419) 526-8000
Fax: (419) 521-7690

The provider's authorized official is Derik K King .
The authorized official title is Llp Managing Partner and has the following contact phone number (866) 916-5259.

The enumeration date for this NPI number is 7/22/2009 and was last updated on 10/16/2009.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207P00000X Emergency Medicine Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 9384421 MEDICARE PIN OH
2 2964734 MEDICAID OH

NPI Record

No. Field Name Field Value
1 NPI 1548490790
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name MID OHIO EMERGENCY PHYSICIANS LLP
5 Provider First Line Business Practice Location Address 335 GLESSNER AVE
6 Provider Business Practice Location Address City Name MANSFIELD
7 Provider Business Practice Location Address State Name OH
8 Provider Business Practice Location Address Postal Code 449032269
9 Provider Business Practice Location Address Country Code If outside U S US
10 Provider Business Practice Location Address Telephone Number 4195268000
11 Provider Business Practice Location Address Fax Number 4195217690
12 Provider Enumeration Date 7/22/2009
13 Last Update Date 10/16/2009
14 Authorized Official Last Name KING
15 Authorized Official First Name DERIK
16 Authorized Official Middle Name K
17 Authorized Official Title or Position LLP MANAGING PARTNER
18 Authorized Official Telephone Number 8669165259
19 Healthcare Provider Taxonomy Code 1 207P00000X
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Other Provider Identifier 1 9384421
22 Other Provider Identifier Type Code 1 08
23 Other Provider Identifier State 1 OH
24 Other Provider Identifier 2 2964734
25 Other Provider Identifier Type Code 2 05
26 Other Provider Identifier State 2 OH
27 Is Organization Subpart N
28 Authorized Official Name Prefix Text DR.
29 Authorized Official Credential Text MD
30 Healthcare Provider Taxonomy Group 1 193200000X MULTI-SPECIALTY GROUP

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This page was last updated on: 8/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.