Provider Demographics
NPI:1417966045
Name:GOTTSCHLING, MARTIN J (D C)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:J
Last Name:GOTTSCHLING
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 S TRIMBLE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-4112
Mailing Address - Country:US
Mailing Address - Phone:419-756-2986
Mailing Address - Fax:419-756-4381
Practice Address - Street 1:605 S TRIMBLE RD
Practice Address - Street 2:SUITE A
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-4112
Practice Address - Country:US
Practice Address - Phone:419-756-2986
Practice Address - Fax:419-756-4381
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1257111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0679556Medicaid
OH341815713003OtherMEDICAL MUTUAL
OH000000139658OtherANTHEM
OH44-00307OtherUNITED HEALTH CARE
GO060364Medicare PIN
OH9280511Medicare ID - Type Unspecified
OH341815713003OtherMEDICAL MUTUAL