Provider Demographics
NPI:1437295953
Name:MINE O. OZKAZANC, MD INC.
Entity Type:Organization
Organization Name:MINE O. OZKAZANC, MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MINE
Authorized Official - Middle Name:O
Authorized Official - Last Name:OZKAZANC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-930-6016
Mailing Address - Street 1:5319 HOAG DRIVE
Mailing Address - Street 2:230
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035
Mailing Address - Country:US
Mailing Address - Phone:440-930-6016
Mailing Address - Fax:440-930-6085
Practice Address - Street 1:5319 HOAG DRIVE
Practice Address - Street 2:230
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035
Practice Address - Country:US
Practice Address - Phone:440-930-6016
Practice Address - Fax:440-930-6085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35072810O208000000X
OH207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2343084Medicaid
OHDD3065OtherRAILROAD MEDICARE
OH2343084Medicaid