Doctor Name: | MR. JOEL SOBECKI |
NPI Number: | 1104181197 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | COA.13466-NP |
Business Practice Address: | 455 W 4th St Suite 100 Fostoria, OH - 448301849 |
Business Phone Number: | 4194366680 |
Business Fax Number: | 4194366681 |
Mailing Address: | 455 W 4th St, Suite 100 FOSTORIA |
State: | OH |
Postal Code: | 448301849 |
Phone Number: | 4194366680 |
Fax Number: | 4194366681 |
NPI Enumeration Date: | 07/06/2012 |
NPI Last Update Date: | 05/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | COA.13466-NP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |