Provider Demographics
NPI:1114914025
Name:AKRON VASCULAR ASSOCIATES INC
Entity Type:Organization
Organization Name:AKRON VASCULAR ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:FINK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-434-4145
Mailing Address - Street 1:95 ARCH ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1437
Mailing Address - Country:US
Mailing Address - Phone:330-434-4145
Mailing Address - Fax:330-375-4985
Practice Address - Street 1:95 ARCH ST
Practice Address - Street 2:SUITE 215
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1437
Practice Address - Country:US
Practice Address - Phone:330-434-4145
Practice Address - Fax:330-375-4985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0845563Medicaid
OHAK9934612Medicare PIN
OHAK9934611Medicare ID - Type UnspecifiedMEDICARE GROUP