Provider Demographics
NPI:1447389259
Name:PERFORMANCE ORTHOPEDIC CENTER
Entity Type:Organization
Organization Name:PERFORMANCE ORTHOPEDIC CENTER
Other - Org Name:ROBERT L DAWSON M.D.,JAMES R. KERBS M.D.,THOMAS J. ZUESI, JAMES WURM,
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:KERBS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-468-7059
Mailing Address - Street 1:PO BOX 704
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-0704
Mailing Address - Country:US
Mailing Address - Phone:419-468-7059
Mailing Address - Fax:
Practice Address - Street 1:955 HOSFORD RD
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-9325
Practice Address - Country:US
Practice Address - Phone:419-468-7059
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006810207QS0010X
OH35058529207X00000X
OH35082136207X00000X
OH4543225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty