| Austin Square Medical Group | |
|
5121 Mahoning Ave Youngstown OH 44515-1847 | |
| (330) 799-3223 | |
| Not Available |
| Full Name | Austin Square Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 5121 Mahoning Ave, Youngstown, Ohio |
| Authorized Official Name and Position | Gregory John Facemyer (OWNER) |
| Authorized Official Contact | 3305337210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Austin Square Medical Group 8023 Maplevale Drive Canfield OH 44406 Ph: (330) 533-7210 | Austin Square Medical Group 5121 Mahoning Ave Youngstown OH 44515-1847 Ph: (330) 799-3223 |
| NPI Number | 1972627065 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 04/01/2020 |
| Medicare PECOS PAC ID | 3577661248 |
|---|---|
| Medicare Enrollment ID | O20070604000254 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972627065 | NPI | - | NPPES |
| 2125542 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35072943F (Ohio) | Primary |
| Provider Name | Gregory Facemyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205823390 PECOS PAC ID: 1254439938 Enrollment ID: I20070604000319 |
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