| Midlothian Medical Center Inc | |
|
2010 E Midlothian Blvd Youngstown OH 44502-2951 | |
| (330) 788-8791 | |
| (330) 788-4033 |
| Full Name | Midlothian Medical Center Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 2010 E Midlothian Blvd, Youngstown, Ohio |
| Authorized Official Name and Position | Russell A Morrison (PRESIDENT OWNER) |
| Authorized Official Contact | 3307888791 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midlothian Medical Center Inc 2010 E Midlothian Blvd Youngstown OH 44502-2951 Ph: (330) 788-8791 | Midlothian Medical Center Inc 2010 E Midlothian Blvd Youngstown OH 44502-2951 Ph: (330) 788-8791 |
| NPI Number | 1407837826 |
|---|---|
| Provider Enumeration Date | 11/11/2005 |
| Last Update Date | 04/20/2008 |
| Medicare PECOS PAC ID | 8527957711 |
|---|---|
| Medicare Enrollment ID | O20040315000627 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407837826 | NPI | - | NPPES |
| 0282171 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Russell A Morrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699773259 PECOS PAC ID: 2163311374 Enrollment ID: I20040315000709 |
| Provider Name | Joseph James Gallo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376540195 PECOS PAC ID: 4183668684 Enrollment ID: I20050615000764 |
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