Manor Avenue Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MANOR AVENUE CLINIC INC

Practice address

296 E Manor Ave
Struthers, OH 44471-1545

Phone

(330) 755-3233

Fax

(330) 755-4511

NPI assigned

Dec 1, 2005

Last updated

Aug 22, 2020By 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

Dr. Andrew J Lockshaw III, DONPI 1265415483

Title

DO

Phone

(330) 755-3233

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrew J Lockshaw III, DO

  • Family Medicine Physician
  • Struthers, OH
  • NPI 1265415483
  Authorized official Same address or phone

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326022625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 E MANOR AVE",
            "city": "STRUTHERS",
            "state": "OH",
            "postal_code": "444711545",
            "telephone_number": "330-755-3233",
            "fax_number": "330-755-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 E MANOR AVE",
            "city": "STRUTHERS",
            "state": "OH",
            "postal_code": "444711545",
            "telephone_number": "330-755-3233",
            "fax_number": "330-755-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR AVENUE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOCKSHAW",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "330-755-3233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0795564",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne Ludwick
• William Ludwick
• Glorivel Lugo
• Jade M Lyden, BA, CT
• Shatiqua C Lyons, LSW
• Leslie M Markulin, LISW-S
• Kyran J McClure
• Paula McCuen
• Juliette Christine McDanel, PT
• Carolyn McGlone

• Family Medicine Physician in Struthers, OH
• Providers in Struthers, 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 Aug 22, 2020; 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.