| Mark E. Davis, D.o. | |
|
341 Youngstown Kingsville Rd Se Vienna OH 44473-9601 | |
| (330) 394-2305 | |
| (330) 394-1405 |
| Full Name | Mark E. Davis, D.o. |
|---|---|
| Speciality | Family Medicine |
| Location | 341 Youngstown Kingsville Rd Se, Vienna, Ohio |
| Authorized Official Name and Position | Mark E Davis (OWNER) |
| Authorized Official Contact | 3303942305 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark E. Davis, D.o. 341 Youngstown Kingsville Rd Se Vienna OH 44473-9601 Ph: (330) 394-2305 | Mark E. Davis, D.o. 341 Youngstown Kingsville Rd Se Vienna OH 44473-9601 Ph: (330) 394-2305 |
| NPI Number | 1639368350 |
|---|---|
| Provider Enumeration Date | 10/18/2007 |
| Last Update Date | 02/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639368350 | NPI | - | NPPES |
| 2056260 | Medicaid | OH | |
| 0797857 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 34-004595 (Ohio) | Primary |
Daniel J. Fitzpatrick, 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 |