Provider Demographics
NPI:1518070804
Name:THE ORTHOPAEDIC NETWORK, INC.
Entity Type:Organization
Organization Name:THE ORTHOPAEDIC NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:GUIDO
Authorized Official - Last Name:ANDRESHAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-517-7500
Mailing Address - Street 1:7630 KINGS POINTE RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1500
Mailing Address - Country:US
Mailing Address - Phone:419-517-7500
Mailing Address - Fax:419-517-7501
Practice Address - Street 1:7630 KINGS POINTE RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1500
Practice Address - Country:US
Practice Address - Phone:419-517-7500
Practice Address - Fax:419-517-7501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE ORTHOPAEDIC NETWORK INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-17
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2581746Medicaid
OH2320867Medicaid
OH=========-02OtherBWC
OH2320867Medicaid
OH4754190003Medicare NSC
OHCJ9324Medicare PIN