Doctor Name: | DR. JANEL GRACEY |
NPI Number: | 1003028622 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 57-010717 |
Business Practice Address: | 2600 6th St Sw Medical Education Canton, OH - 447101702 |
Business Phone Number: | 3303634899 |
Business Fax Number: | 3305805513 |
Mailing Address: | 2600 6th St Sw, Medical Education CANTON |
State: | OH |
Postal Code: | 447101702 |
Phone Number: | 3303634899 |
Fax Number: | 3305805513 |
NPI Enumeration Date: | 05/04/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 57-010717 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |