Provider Demographics
NPI:1497939409
Name:JOHN P. FERRON, M.D. & TIMOTHY J. PRITCHARD, M.D. INC
Entity Type:Organization
Organization Name:JOHN P. FERRON, M.D. & TIMOTHY J. PRITCHARD, M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:FERRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-354-0377
Mailing Address - Street 1:9500 MENTOR AVE SUITE 300
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060
Mailing Address - Country:US
Mailing Address - Phone:440-354-0377
Mailing Address - Fax:440-354-9368
Practice Address - Street 1:9500 MENTOR AVE SUITE 300
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060
Practice Address - Country:US
Practice Address - Phone:440-354-0377
Practice Address - Fax:440-354-9368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2160665Medicaid
OH2160665Medicaid