MEDCENTRAL PROFESSIONAL FOUNDATION LLC NPI 1841476942

NPI Information

NPI: 1841476942
Provider Name: MEDCENTRAL PROFESSIONAL FOUNDATION, LLC
Classification: Otolaryngology - 207YS0123X
Entity Type: Organization

Specialization: Facial Plastic Surgery

Address:
308 GLESSNER AVENUE
MANSFIELD, OH
ZIP 44903
Phone: (419) 526-8962
Get Directions

MEDCENTRAL PROFESSIONAL FOUNDATION, LLC is a facial plastic surgery otolaryngology in Mansfield, OH. The provider is an otolaryngologist who specializes in facial plastic surgery. MEDCENTRAL PROFESSIONAL FOUNDATION, LLC NPI is 1841476942. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

308 GLESSNER AVENUE
MANSFIELD, OH
ZIP 44903-269
Phone: (419) 526-8962
Fax: (419) 526-8834

The provider's authorized official is Joseph L Chamberlain .
The authorized official title is Ceo/cfo and has the following contact phone number (419) 526-8000.

The enumeration date for this NPI number is 1/18/2008 and was last updated on 9/17/2013.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207L00000X	Anesthesiology				No
2	207R00000X	Internal Medicine				No
3	207RE0101X	Internal Medicine	Endocrinology, Diabetes & Metabolism	35-07-2694-D	OHIO	No
4	207RP1001X	Internal Medicine	Pulmonary Disease			No
5	207T00000X	Neurological Surgery		35090672	OHIO	No
6	207X00000X	Orthopaedic Surgery				No
7	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery)				No
8	207RR0500X	Internal Medicine	Rheumatology			No
9	207LP2900X	Anesthesiology	Pain Medicine			No
10	208600000X	Surgery				No
11	207V00000X	Obstetrics & Gynecology				No
12	207YS0123X	Otolaryngology	Facial Plastic Surgery			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2810131	MEDICAID	OHIO
2	9374381	MEDICARE PIN

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

NPI Synchronization or Removal

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