Provider Demographics
NPI:1992842256
Name:ORTHOPEDIC ASSOCIATES OF LAKE CO INC
Entity Type:Organization
Organization Name:ORTHOPEDIC ASSOCIATES OF LAKE CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPEDIC SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:440-350-9595
Mailing Address - Street 1:7551 FREDLE DR
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-9406
Mailing Address - Country:US
Mailing Address - Phone:440-350-9595
Mailing Address - Fax:440-357-1905
Practice Address - Street 1:7551 FREDLE DR
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-9406
Practice Address - Country:US
Practice Address - Phone:440-350-9595
Practice Address - Fax:440-357-1905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHOR9300172Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
OH0290400001Medicare NSC