| Austin Primary Care Llc | |
|
101 5th Street Se Suite G Barberton OH 44203-4225 | |
| (330) 745-3151 | |
| (330) 745-9984 |
| Full Name | Austin Primary Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 101 5th Street Se, Barberton, Ohio |
| Authorized Official Name and Position | John C Cook (PRESIDENT) |
| Authorized Official Contact | 3307453151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Austin Primary Care Llc 101 5th Street Se Suite G Barberton OH 44203-4225 Ph: (330) 745-3151 | Austin Primary Care Llc 101 5th Street Se Suite G Barberton OH 44203-4225 Ph: (330) 745-3151 |
| NPI Number | 1528227964 |
|---|---|
| Provider Enumeration Date | 06/02/2008 |
| Last Update Date | 07/29/2014 |
| Medicare PECOS PAC ID | 1759454812 |
|---|---|
| Medicare Enrollment ID | O20080723000006 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528227964 | NPI | - | NPPES |
| 9054194 | Other | AETNA | |
| 2841661 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (Ohio) | Primary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| Provider Name | John C Cook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467443580 PECOS PAC ID: 8820078538 Enrollment ID: I20060105000499 |
| Provider Name | Lee Ann Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942485412 PECOS PAC ID: 1355427527 Enrollment ID: I20080327000828 |
| Provider Name | Marcy L Gonczy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306220363 PECOS PAC ID: 0446553382 Enrollment ID: I20160126002507 |
| Provider Name | Stephen B Mcnulty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972066611 PECOS PAC ID: 2769711555 Enrollment ID: I20220725003218 |
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