Provider Demographics
NPI:1639153760
Name:GINLEY, PATRICK JOSEPH III (PA-C)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:GINLEY
Suffix:III
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1492 NORTHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3720
Mailing Address - Country:US
Mailing Address - Phone:216-228-6925
Mailing Address - Fax:
Practice Address - Street 1:CLEVELAND CLINIC, DEPT. OF COLORECTAL SURGERY
Practice Address - Street 2:9500 EUCLID AVENUE, DESK A30
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-4185
Practice Address - Fax:216-445-8627
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50-00-1375363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical