| Wyandot Medical Providers At Tarhe | |
|
245 Tarhe Trl Upper Sandusky OH 43351-8700 | |
| (419) 294-1525 | |
| (419) 209-0252 |
| Full Name | Wyandot Medical Providers At Tarhe |
|---|---|
| Speciality | Clinic/Center |
| Location | 245 Tarhe Trl, Upper Sandusky, Ohio |
| Authorized Official Name and Position | Ty R Shaull (PRESIDENT & CEO) |
| Authorized Official Contact | 4192944991 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wyandot Medical Providers At Tarhe 885 N Sandusky Ave Upper Sandusky OH 43351-1098 Ph: (419) 294-4991 | Wyandot Medical Providers At Tarhe 245 Tarhe Trl Upper Sandusky OH 43351-8700 Ph: (419) 294-1525 |
| NPI Number | 1720594971 |
|---|---|
| Provider Enumeration Date | 12/26/2017 |
| Last Update Date | 08/11/2022 |
| Medicare PECOS PAC ID | 1557340189 |
|---|---|
| Medicare Enrollment ID | O20180221001346 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720594971 | NPI | - | NPPES |
| 0394798 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Upper Sandusky Medical Assoc Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 777 N Sandusky Ave, Upper Sandusky, OH 43351 Phone: 419-294-2375 Fax: 419-294-2412 | |
Kyu Park Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Houpt Dr, Upper Sandusky, OH 43351 Phone: 419-294-5757 Fax: 419-209-0623 |