Basic Information
Provider Information
NPI: 1003804329
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOWARD
FirstName: BRETT
MiddleName: E
NamePrefix: MR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 600 W. THIRD STREET
Address2:  
City: MANSFIELD
State: OH
PostalCode: 449062633
CountryCode: US
TelephoneNumber: 4195226191
FaxNumber: 4195220493
Practice Location
Address1: 600 W. THIRD STREET
Address2:  
City: MANSFIELD
State: OH
PostalCode: 449062633
CountryCode: US
TelephoneNumber: 4195226191
FaxNumber: 4195220493
Other Information
ProviderEnumerationDate: 10/11/2005
LastUpdateDate: 05/18/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X35075173TOHN Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000X35075173OHY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
933740801HICIGNAOTHER
00000022391001OHANTHEMOTHER
010904401OHUNITEDHEALTHCAREOTHER
0367601OHPARAMOUNTOTHER
210055005OH MEDICAID
08018377201OHRAILROAD MEDICAREOTHER


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