Provider Demographics
NPI:1437324605
Name:IDOINE, JOHN DOUGLAS III (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DOUGLAS
Last Name:IDOINE
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4760 BELPAR ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3603
Mailing Address - Country:US
Mailing Address - Phone:330-492-9200
Mailing Address - Fax:
Practice Address - Street 1:340 OXFORD ST STE 102
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-1969
Practice Address - Country:US
Practice Address - Phone:330-492-9200
Practice Address - Fax:330-492-5454
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.010236207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery