Basic Information
| Provider Information | |||||||||
| NPI: | 1578537825 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FAMILY PHYSICIANS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4860 FRANK RD NW | ||||||||
| Address2: | |||||||||
| City: | NORTH CANTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 447207426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304947099 | ||||||||
| FaxNumber: | 3304942147 | ||||||||
| Practice Location | |||||||||
| Address1: | 4860 FRANK RD NW | ||||||||
| Address2: | |||||||||
| City: | NORTH CANTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 447207426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304947099 | ||||||||
| FaxNumber: | 3304942147 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2006 | ||||||||
| LastUpdateDate: | 03/20/2017 | ||||||||
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| AuthorizedOfficialLastName: | HUPP | ||||||||
| AuthorizedOfficialFirstName: | AMY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 3309663149 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0461763 | 05 | OH | MEDICAID | CB2203 | 01 | OH | RAILROAD MEDICARE | OTHER |