| Todd Forrest Do Llc | |
|
119 Clinton St Maumee OH 43537-2811 | |
| (419) 893-8985 | |
| (419) 893-6766 |
| Full Name | Todd Forrest Do Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 119 Clinton St, Maumee, Ohio |
| Authorized Official Name and Position | Todd Forrest (OWNER) |
| Authorized Official Contact | 4198938985 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Todd Forrest Do Llc 119 Clinton St Maumee OH 43537-2811 Ph: (419) 893-8985 | Todd Forrest Do Llc 119 Clinton St Maumee OH 43537-2811 Ph: (419) 893-8985 |
| NPI Number | 1356523740 |
|---|---|
| Provider Enumeration Date | 11/28/2007 |
| Last Update Date | 11/28/2007 |
| Medicare PECOS PAC ID | 5597775361 |
|---|---|
| Medicare Enrollment ID | O20060425000481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356523740 | NPI | - | NPPES |
| 0620377 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3845 (Ohio) | Primary |
| Provider Name | Todd R Forrest |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831187103 PECOS PAC ID: 0244251684 Enrollment ID: I20060426000001 |
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