1437295953 NPI number — MINE O. OZKAZANC, MD INC.

Table of content: (NPI 1437295953)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437295953 NPI number — MINE O. OZKAZANC, MD INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MINE O. OZKAZANC, MD INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437295953
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5319 HOAG DRIVE
Provider Second Line Business Mailing Address:
230
Provider Business Mailing Address City Name:
ELYRIA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44035
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-930-6016
Provider Business Mailing Address Fax Number:
440-930-6085

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5319 HOAG DRIVE
Provider Second Line Business Practice Location Address:
230
Provider Business Practice Location Address City Name:
ELYRIA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-930-6016
Provider Business Practice Location Address Fax Number:
440-930-6085
Provider Enumeration Date:
01/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
OZKAZANC
Authorized Official First Name:
MINE
Authorized Official Middle Name:
O
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
440-930-6016

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  35072810O , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2343084 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: DD3065 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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