| Wyandot Medical Providers At Sycamore | |
|
412 W Saffel Ave Sycamore OH 44882-9763 | |
| (419) 927-6552 | |
| (419) 927-6500 |
| Full Name | Wyandot Medical Providers At Sycamore |
|---|---|
| Speciality | Clinic/Center |
| Location | 412 W Saffel Ave, Sycamore, 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 Sycamore 885 N Sandusky Ave Upper Sandusky OH 43351-1098 Ph: (419) 294-4991 | Wyandot Medical Providers At Sycamore 412 W Saffel Ave Sycamore OH 44882-9763 Ph: (419) 927-6552 |
| NPI Number | 1275033011 |
|---|---|
| Provider Enumeration Date | 02/19/2018 |
| Last Update Date | 08/17/2022 |
| Medicare PECOS PAC ID | 1557340189 |
|---|---|
| Medicare Enrollment ID | O20180410002345 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275033011 | NPI | - | NPPES |
| 9687512 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Wyandot Memorial Hospital Physician Services B Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 N Pennington St, Sycamore, OH 44882 Phone: 419-927-6552 Fax: 419-927-6500 | |
Sycamore Medical Associates, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 N Pennington St, Sycamore, OH 44882 Phone: 419-927-6552 Fax: 419-927-6500 |