Provider Demographics
NPI:1679826010
Name:STARK COUNTY EMERGENCY PHYSICIANS
Entity Type:Organization
Organization Name:STARK COUNTY EMERGENCY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD, VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:KAEBERLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-489-1365
Mailing Address - Street 1:5154 FULTON DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2365
Mailing Address - Country:US
Mailing Address - Phone:330-499-8837
Mailing Address - Fax:
Practice Address - Street 1:5154 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2365
Practice Address - Country:US
Practice Address - Phone:330-499-8837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH363A00000X282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital