Provider Demographics
NPI:1558321927
Name:NORTH CENTRAL FAMILY PHYSICIANS INC
Entity Type:Organization
Organization Name:NORTH CENTRAL FAMILY PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:419-484-7700
Mailing Address - Street 1:PO BOX 419
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:OH
Mailing Address - Zip Code:44811-0419
Mailing Address - Country:US
Mailing Address - Phone:440-716-1283
Mailing Address - Fax:440-716-1605
Practice Address - Street 1:420 W MCPHERSON HWY
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:OH
Practice Address - Zip Code:43410-1133
Practice Address - Country:US
Practice Address - Phone:419-547-0584
Practice Address - Fax:419-547-8918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========01OtherWORKERS COMP
OH=========OtherTRICARE
OHDC1163Medicare ID - Type UnspecifiedRAILROAD
OH9348671Medicare PIN
OH=========OtherTRICARE