Mansfield Family Practice

LBN: Mansfield Family Practice
Mansfield Family Practice is an health care organization with primary practice located at 248 Blymyer Ave , Mansfield OH 44903-2306. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Mansfield Family Practice can be contacted via phone (419) 524-2212, or through Gardner, Raymond John via phone (419) 524-2212.

Contact Information

Primary practice address
248 Blymyer Ave Mansfield OH 44903-2306
Phone: (419) 524-2212
Fax: (419) 524-9040
Website:
Map and Directions
Authorized official contact:
Name: Gardner, Raymond John Doctor of Medicine (MD)
Phone: (419) 524-2212

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Ohio

Profile Details

NPI number 1104823889
LBN Legal business name Mansfield Family Practice
DBA Doing business as
Authorized official Gardner, Raymond John Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 7th, 2005
Last updated Jul 21st, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104823889 NPPES
Ohio MEDICAID 2261234

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