Patrio D Tismo PA Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

33966 Issued in OH

Legal business name

PATRIO D TISMO PA INC

Practice address

107 North 3Rd Street
Ironton, OH 45638

Phone

(740) 532-0059

Fax

(740) 532-0380

NPI assigned

Nov 18, 2010

Last updated

Oct 18, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Patrio D Tismo, M.D.

Title

Owner

Phone

(740) 532-0059

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1290038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1245532654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 500",
            "address_2": "107 NORTH 3RD STREET",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "45638",
            "telephone_number": "740-532-0059",
            "fax_number": "740-532-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 NORTH 3RD STREET",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "45638",
            "telephone_number": "740-532-0059",
            "fax_number": "740-532-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRIO D TISMO PA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-18",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "TISMO",
        "authorized_official_first_name": "PATRIO",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-532-0059",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "33966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0175706",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaylin Shavonne Parker
• Sujdtra Parker
• Morgan Parks
• Bonnie Renee Patrick, APRN
• Peyton Patrick
• Patriot Emergency Medical Service (Lawrence County Emergency Medical Service)
• Patriot Emergency Medical Services (Patriot EMS)
• Patriot Management and Investments Company LLC (Patriot EMS)
• Jarod Patterson, LCDCIII, QMHS
• Latesha Patterson

• Family Medicine Physician in Ironton, OH
• Providers in Ironton, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.