Provider Demographics
NPI:1871603894
Name:NORTH CENTRAL FAMILY PHYSICIANS, INC
Entity type:Organization
Organization Name:NORTH CENTRAL FAMILY PHYSICIANS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:419-483-6460
Mailing Address - Street 1:PO BOX 419
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:OH
Mailing Address - Zip Code:44811-0419
Mailing Address - Country:US
Mailing Address - Phone:440-716-1283
Mailing Address - Fax:440-716-1605
Practice Address - Street 1:521 N SANDUSKY ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:OH
Practice Address - Zip Code:44811-1180
Practice Address - Country:US
Practice Address - Phone:419-483-6460
Practice Address - Fax:419-483-2379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========02OtherBUREAU OF WORKERS COMP
OHDC1163Medicare ID - Type UnspecifiedRAILROAD MEDICARE
OH9348671Medicare PIN
OH=========02OtherBUREAU OF WORKERS COMP