| Mansfield Family Practice | |
|
248 Blymyer Ave Mansfield OH 44903-2306 | |
| (419) 524-2212 | |
| (419) 524-9040 |
| Full Name | Mansfield Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 248 Blymyer Ave, Mansfield, Ohio |
| Authorized Official Name and Position | Raymond John Gardner (PARTNER) |
| Authorized Official Contact | 4195242212 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mansfield Family Practice 248 Blymyer Ave Mansfield OH 44903-2306 Ph: (419) 524-2212 | Mansfield Family Practice 248 Blymyer Ave Mansfield OH 44903-2306 Ph: (419) 524-2212 |
| NPI Number | 1104823889 |
|---|---|
| Provider Enumeration Date | 07/07/2005 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104823889 | NPI | - | NPPES |
| 2261234 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Ohio) | Primary |
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