Provider Demographics
NPI:1942237276
Name:PARTNERS IN FAMILY PRACTICE
Entity Type:Organization
Organization Name:PARTNERS IN FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:330-478-4132
Mailing Address - Street 1:4048 DRESSLER RD NW
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2784
Mailing Address - Country:US
Mailing Address - Phone:330-478-4132
Mailing Address - Fax:330-478-3341
Practice Address - Street 1:4048 DRESSLER RD NW
Practice Address - Street 2:SUITE 203
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2784
Practice Address - Country:US
Practice Address - Phone:330-478-4132
Practice Address - Fax:330-478-3341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2491638Medicaid
OH2491638Medicaid