Provider Demographics
NPI:1790970234
Name:JOHN O. VLAD MD, INC.
Entity Type:Organization
Organization Name:JOHN O. VLAD MD, INC.
Other - Org Name:VLAD PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:OVID
Authorized Official - Last Name:VLAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-841-7337
Mailing Address - Street 1:2219 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6105
Mailing Address - Country:US
Mailing Address - Phone:330-841-7337
Mailing Address - Fax:330-841-7329
Practice Address - Street 1:2219 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6105
Practice Address - Country:US
Practice Address - Phone:330-841-7337
Practice Address - Fax:330-841-7329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-024361-V208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0048460Medicaid
OHA70531Medicare UPIN