Provider Demographics
NPI:1801300843
Name:JOHN SCHINNER, M.D. LLC
Entity type:Organization
Organization Name:JOHN SCHINNER, M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-345-8060
Mailing Address - Street 1:128 E MILLTOWN RD STE 105
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-1276
Mailing Address - Country:US
Mailing Address - Phone:330-345-8060
Mailing Address - Fax:330-345-5983
Practice Address - Street 1:128 E MILLTOWN RD STE 105
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-1276
Practice Address - Country:US
Practice Address - Phone:330-345-8060
Practice Address - Fax:330-345-5983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0089017Medicaid