Active NPI
Tusc County Medical Specialties LLC
- Gastroenterology Physician
- Dover, OH
National Provider Identifier
1518156074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 55408
- Legal business name
- TUSC COUNTY MEDICAL SPECIALTIES LLC
- Practice address
- 300 Medical Park Dr
Suite 205
Dover, OH 44622-2073 - Phone
- (330) 364-4600
- Fax
- (330) 364-3338
- NPI assigned
- Oct 22, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Blair Thomas Holder, M.D.
- Title
- M.D.
- Phone
- (330) 364-4600
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 55408 | OH | Primary |
Addresses
Primary practice location
300 Medical Park Dr
Suite 205
Dover, OH 44622-2073
Mailing address
300 Medical Park Dr
Suite 205
Dover, OH 44622-2073
Phone (330) 364-4600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110192418 | Other | OH | RAILROAD MEDICARE |
| 2102101 | Medicaid | OH |
National Provider Directory
National Provider DirectoryLocations
216 W 3rd St
Dover, OH 44622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193011200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1578268800000",
"number": "1518156074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 MEDICAL PARK DR",
"address_2": "SUITE 205",
"city": "DOVER",
"state": "OH",
"postal_code": "446222073",
"telephone_number": "330-364-4600",
"fax_number": "330-364-3338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 MEDICAL PARK DR",
"address_2": "SUITE 205",
"city": "DOVER",
"state": "OH",
"postal_code": "446222073",
"telephone_number": "330-364-4600",
"fax_number": "330-364-3338"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TUSC COUNTY MEDICAL SPECIALTIES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-22",
"last_updated": "2020-01-06",
"certification_date": "2020-01-06",
"status": "A",
"authorized_official_last_name": "HOLDER",
"authorized_official_first_name": "BLAIR",
"authorized_official_middle_name": "THOMAS",
"authorized_official_title_or_position": "M.D.",
"authorized_official_telephone_number": "330-364-4600",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": "OH",
"license": "55408",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110192418",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2102101",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dover, OH
- Elizabeth K Thompson, LPN
- Trinity Hospital Twin City (Twin City Medical Center)
- Jill Suzanne Tucker
- Tracy Louise Turck, LPN
- Tusc County Medical Specialist LLC (Tusc County Medical Specialist)
- Tuscarawas Ambulatory Surgery Center, LLC
- Tuscarawas County (Tuscarawas County Dental)
- Tuscarawas County Auditor (Tuscarwas County General Health District Dental Program)
- Tuscarawas County Auditor (Alcohol and Addiction Program)
- Tuscarawas County Auditor
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.