Provider Demographics
NPI:1639156557
Name:EBNER, THOMAS GHARET (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:GHARET
Last Name:EBNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:970 E WASHINGTON
Mailing Address - Street 2:STE 102 THOMAS G EBNER & ASSOCIATES
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256
Mailing Address - Country:US
Mailing Address - Phone:330-722-1610
Mailing Address - Fax:330-722-1610
Practice Address - Street 1:3880 E SMITH RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8771
Practice Address - Country:US
Practice Address - Phone:330-722-1175
Practice Address - Fax:330-722-1175
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35031766207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0207707Medicaid
OH0207707Medicaid
A74904Medicare UPIN
A74904Medicare UPIN