Provider Demographics
NPI:1164452348
Name:NORTHWEST OHIO PRIMARY CARE PHYSICIANS, INC.
Entity Type:Organization
Organization Name:NORTHWEST OHIO PRIMARY CARE PHYSICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-833-4700
Mailing Address - Street 1:20311 PEMBERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PEMBERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43450-9413
Mailing Address - Country:US
Mailing Address - Phone:419-833-4700
Mailing Address - Fax:419-833-7401
Practice Address - Street 1:20311 PEMBERVILLE RD
Practice Address - Street 2:
Practice Address - City:PEMBERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43450-9413
Practice Address - Country:US
Practice Address - Phone:419-833-4700
Practice Address - Fax:419-833-7401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35057334207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1598755712OtherNPI
OH0793468Medicaid
OH0793468Medicaid
OH1598755712OtherNPI