Provider Demographics
NPI:1265500953
Name:MANSFIELD OBSTETRICS & GYNECOLOGY ASSOCIATES INC
Entity Type:Organization
Organization Name:MANSFIELD OBSTETRICS & GYNECOLOGY ASSOCIATES INC
Other - Org Name:WOMEN'S CARE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE TEAM LEADER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MAYNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-756-6000
Mailing Address - Street 1:500 S TRIMBLE RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-4103
Mailing Address - Country:US
Mailing Address - Phone:419-756-6000
Mailing Address - Fax:419-756-1774
Practice Address - Street 1:500 S TRIMBLE RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-4103
Practice Address - Country:US
Practice Address - Phone:419-756-6000
Practice Address - Fax:419-756-8721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0199164Medicaid
OH0199164Medicaid
OH9918152Medicare PIN