| Daniel J. Fitzpatrick, D.o. | |
|
341 Youngstown Kingsville Rd Se Vienna OH 44473-9601 | |
| (330) 394-2305 | |
| (330) 394-1405 |
| Full Name | Daniel J. Fitzpatrick, D.o. |
|---|---|
| Speciality | Family Medicine - Adolescent Medicine |
| Location | 341 Youngstown Kingsville Rd Se, Vienna, Ohio |
| Authorized Official Name and Position | Daniel Fitzpatrick (OWNER) |
| Authorized Official Contact | 3303941405 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel J. Fitzpatrick, D.o. 2219 E Market St Warren OH 44483-6105 Ph: (330) 394-2305 | Daniel J. Fitzpatrick, D.o. 341 Youngstown Kingsville Rd Se Vienna OH 44473-9601 Ph: (330) 394-2305 |
| NPI Number | 1083999098 |
|---|---|
| Provider Enumeration Date | 10/21/2011 |
| Last Update Date | 10/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083999098 | NPI | - | NPPES |
| 0629627 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0000X | Family Medicine - Adolescent Medicine | 30-00-3237 (Ohio) | Primary |
Mark E. Davis, D.o. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 341 Youngstown Kingsville Rd Se, Vienna, OH 44473 Phone: 330-394-2305 Fax: 330-394-1405 |