WOODSIDE MEDICAL GROUP INC. NPI 1821148404

NPI Information

WOODSIDE MEDICAL GROUP, INC. is a medical specialty clinic center in Mansfield, OH. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). WOODSIDE MEDICAL GROUP, INC. NPI is 1821148404. The provider is registered as an organization entity type.

The provider's business location address is:

475 LEXINGTON AVE
MANSFIELD, OH
ZIP 44907-501
Phone: (419) 756-2003
Fax: (419) 756-3637

The provider's authorized official is Robert Edwin Exten .
The authorized official title is Pres and has the following contact phone number (419) 756-2003.

The enumeration date for this NPI number is 1/12/2007 and was last updated on 10/4/2011.

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:

Other Identifiers

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

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