| E. A. Dechellis, D.o., Inc. | |
|
3002 State Route 5 Ste B Cortland OH 44410-9202 | |
| (330) 637-1000 | |
| (330) 637-9905 |
| Full Name | E. A. Dechellis, D.o., Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 3002 State Route 5 Ste B, Cortland, Ohio |
| Authorized Official Name and Position | Ernest A Dechellis (OWNER) |
| Authorized Official Contact | 3306371000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| E. A. Dechellis, D.o., Inc. 3002 State Route 5 Ste B Cortland OH 44410-9202 Ph: (330) 637-1000 | E. A. Dechellis, D.o., Inc. 3002 State Route 5 Ste B Cortland OH 44410-9202 Ph: (330) 637-1000 |
| NPI Number | 1720365430 |
|---|---|
| Provider Enumeration Date | 11/09/2011 |
| Last Update Date | 11/09/2011 |
| Medicare PECOS PAC ID | 5294900783 |
|---|---|
| Medicare Enrollment ID | O20111212000693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720365430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4006 (Ohio) | Primary |
| Provider Name | Ernest A Dechellis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821040064 PECOS PAC ID: 7810162302 Enrollment ID: I20111212000725 |
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