Provider Demographics
NPI:1114049079
Name:TWIN OAKS PEDIATRICS
Entity Type:Organization
Organization Name:TWIN OAKS PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRON
Authorized Official - Middle Name:
Authorized Official - Last Name:TORSEKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-292-0191
Mailing Address - Street 1:3949 SUNFOREST CT STE 203
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4454
Mailing Address - Country:US
Mailing Address - Phone:419-292-0191
Mailing Address - Fax:
Practice Address - Street 1:3949 SUNFOREST CT STE 203
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4454
Practice Address - Country:US
Practice Address - Phone:419-292-0191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35042395208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0802260Medicaid