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9500 Mentor Ave Suite 100 Mentor OH 44060-8713 | |
(440) 352-4880 | |
(440) 352-3629 |
Full Name | |
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Speciality | Family Medicine |
Location | 9500 Mentor Ave, Mentor, Ohio |
Authorized Official Name and Position | Robert B Tracz (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 4403541642 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 715165 Columbus OH 43271-0001 Ph: (440) 352-4880 | 9500 Mentor Ave Suite 100 Mentor OH 44060-8713 Ph: (440) 352-4880 |
NPI Number | 1821253048 |
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Provider Enumeration Date | 07/28/2008 |
Last Update Date | 07/28/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821253048 | NPI | - | NPPES |
LA9368241 | Other | OH | MEDICARE GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
University Primary Care Practices Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9000 Mentor Ave Ste 204, Mentor, OH 44060 Phone: 216-383-0100 Fax: 216-383-6481 | |
Lake County Family Practice, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9500 Mentor Avenue, Suite 100, Mentor, OH 44060 Phone: 440-352-4880 Fax: 440-352-3629 | |
Hackett Medical Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8300 Tyler Blvd, Suite 300, Mentor, OH 44060 Phone: 440-205-1529 Fax: 440-205-0840 | |
Bowersox Wound Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6966 Heisley Rd Ste F, Mentor, OH 44060 Phone: 440-488-4575 | |
Wound Think Consulting, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5452 Grace Dr, Mentor, OH 44060 Phone: 440-227-2000 | |
Suhas Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9110 Mentor Ave Ste 9b, Mentor, OH 44060 Phone: 440-701-8030 |