| Dr Mary Jane Mangen, MD | |
|
725 S Shoop Ave, Wauseon, OH 43567-1702 | |
| (419) 335-2015 | |
| (419) 330-2774 |
| Full Name | Dr Mary Jane Mangen |
|---|---|
| Gender | Female |
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 725 S Shoop Ave, Wauseon, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205882263 | NPI | - | NPPES |
| 0860733 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 35058814 (Ohio) | Primary |
| Entity Name | Fchc Medical Care, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598821175 PECOS PAC ID: 8022018704 Enrollment ID: O20070103000005 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mary Jane Mangen, MD 725 S Shoop Ave, Wauseon, OH 43567-1702 Ph: (419) 335-2015 | Dr Mary Jane Mangen, MD 725 S Shoop Ave, Wauseon, OH 43567-1702 Ph: (419) 335-2015 |
Benjamin Timothy Forrester, DO Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 725 S Shoop Ave, Wauseon, OH 43567 Phone: 419-335-2015 | |
Dr. George R Williams Iii, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 725 S Shoop Ave, Wauseon, OH 43567 Phone: 419-335-2015 Fax: 419-330-2649 | |
Dr. Stephen Andrew Cox, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 725 S Shoop Ave, Wauseon, OH 43567 Phone: 419-330-2774 Fax: 419-330-2774 |