Medetc LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35052128 Issued in OH

Legal business name

MEDETC LLC

Practice address

2718 Carolyn Dr
Lima, OH 45807-2310

Phone

(419) 302-3337

NPI assigned

Mar 26, 2011

Organization subpart

No

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

Authorized official

Name

Laura Jean Waldron, MD

Title

President

Phone

(419) 303-3466

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1301097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301097600000",
    "number": "1487953634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2718 CAROLYN DR",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458072310",
            "telephone_number": "419-302-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2718 CAROLYN DR",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458072310",
            "telephone_number": "419-302-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDETC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-26",
        "last_updated": "2011-03-26",
        "status": "A",
        "authorized_official_last_name": "WALDRON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-303-3466",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35052128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan J McNeilan, M.D.
• Patricia D McNeill
• Sherree Meade
• Marietta J Medel, MD
• Sampath Medepalli, MD
• Medi Lab Inc
• Rhonda J Medina, M.D.
• Catrese Medley, LPN
• Tammy Gail Meeks
• Ashley Meihls

• Family Medicine Physician in Lima, OH
• Providers in Lima, 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 Mar 26, 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.