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1601 Brigham Dr Suite 250 Perrysburg OH 43551-7114 | |
| (419) 872-5865 | |
| (419) 874-7758 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 1601 Brigham Dr, Perrysburg, Ohio |
| Authorized Official Name and Position | Kenya Dixon (CREDENTIALING ASSISTANT) |
| Authorized Official Contact | 4198247288 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1601 Brigham Dr Suite 250 Perrysburg OH 43551-7114 Ph: (419) 872-5865 | 1601 Brigham Dr Suite 250 Perrysburg OH 43551-7114 Ph: (419) 872-5865 |
| NPI Number | 1376684688 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 02/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376684688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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James P. Stupak, D.c., Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 580 Craig Dr # 8-133, Perrysburg, OH 43551 Phone: 316-992-6338 | |
Syl-haven Medical Clinic, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 W 3rd St, Perrysburg, OH 43551 Phone: 419-794-1006 Fax: 419-873-6599 | |
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