Provider Demographics
NPI:1346458379
Name:SHARON GEORGE DO INC
Entity Type:Organization
Organization Name:SHARON GEORGE DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOLENE
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:KOVACS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-898-4300
Mailing Address - Street 1:420 SOUTHERN BLVD NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44485-2537
Mailing Address - Country:US
Mailing Address - Phone:330-898-4300
Mailing Address - Fax:330-898-5828
Practice Address - Street 1:420 SOUTHERN BLVD NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44485-2537
Practice Address - Country:US
Practice Address - Phone:330-898-4300
Practice Address - Fax:330-898-5828
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHARON GEORGE DO INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-21
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34005112207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH010044662OtherRAILROAD MEDICARE
OH1346458379OtherWORKERS COMPENSATION
OH000000168372OtherANTHEM
OH2980207Medicaid
9309851Medicare PIN