Provider Type Icon

PORTAGE FAMILY PRACTICE CLINIC INC. NPI 1083767677


NPI Information

NPI: 1083767677
Provider Name: PORTAGE FAMILY PRACTICE CLINIC, INC.
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
1413 PORTAGE ST NW
NORTH CANTON, OH
ZIP 44720
Phone: (330) 499-7591
Get Directions

PORTAGE FAMILY PRACTICE CLINIC, INC. is a clinic center in North Canton, OH. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PORTAGE FAMILY PRACTICE CLINIC, INC. NPI is 1083767677. The provider is registered as an organization entity type.

The provider's business location address is:

1413 PORTAGE ST NW
NORTH CANTON, OH
ZIP 44720-288
Phone: (330) 499-7591
Fax: (330) 499-0308

The provider's authorized official is Leonard D Tamburro .
The authorized official title is President and has the following contact phone number (330) 499-7591.

The enumeration date for this NPI number is 1/19/2007 and was last updated on 10/25/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/Center34003002OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========00OTHEROHIOWORKERS COMPENSATION
20507268MEDICAIDOHIO
3PO9268521MEDICARE ID-TYPE UNSPECIFIEDOHIOGROUP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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.