Basic Information
| Provider Information | |||||||||
| NPI: | 1922392935 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRUMAN | ||||||||
| FirstName: | PATTY | ||||||||
| MiddleName: | JO | ||||||||
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| Credential: | D.O | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9620 CRACKEL RD | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442029615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405412791 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 20000 HARVARD AVE | ||||||||
| Address2: | |||||||||
| City: | WARRENSVILLE HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441226805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2164916000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2011 | ||||||||
| LastUpdateDate: | 06/07/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.