Provider Demographics
NPI:1598937385
Name:RICHARD L. CATTERLIN, D.O., INC.
Entity Type:Organization
Organization Name:RICHARD L. CATTERLIN, D.O., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:CATTERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-652-6556
Mailing Address - Street 1:1360 N CANFIELD NILES RD
Mailing Address - Street 2:
Mailing Address - City:MINERAL RIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:44440-9600
Mailing Address - Country:US
Mailing Address - Phone:330-652-6556
Mailing Address - Fax:330-652-6390
Practice Address - Street 1:1360 N CANFIELD NILES RD
Practice Address - Street 2:
Practice Address - City:MINERAL RIDGE
Practice Address - State:OH
Practice Address - Zip Code:44440-9600
Practice Address - Country:US
Practice Address - Phone:330-652-6556
Practice Address - Fax:330-652-6390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-003053C207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2096164Medicaid