Basic Information
Provider Information
NPI: 1609903830
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FLANAGAN
FirstName: JOHN
MiddleName: PATRICK
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 525 E MARKET ST
Address2: PO BOX 2090
City: AKRON
State: OH
PostalCode: 443041619
CountryCode: US
TelephoneNumber: 3309968603
FaxNumber: 3309968695
Practice Location
Address1: 444 N MAIN ST
Address2:  
City: AKRON
State: OH
PostalCode: 443103110
CountryCode: US
TelephoneNumber: 3303756363
FaxNumber: 3303795144
Other Information
ProviderEnumerationDate: 02/27/2007
LastUpdateDate: 02/19/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/19/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X35030974OHY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

ID Information
IDTypeStateIssuerDescription
034581705OH MEDICAID


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