Provider Demographics
NPI:1215060587
Name:W KEVIN LONSDORF MD INC AND ALBERT A FELTRUP JR MD INC
Entity type:Organization
Organization Name:W KEVIN LONSDORF MD INC AND ALBERT A FELTRUP JR MD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:K
Authorized Official - Last Name:WHETSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-645-0153
Mailing Address - Street 1:2818 S ARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-4716
Mailing Address - Country:US
Mailing Address - Phone:330-645-0153
Mailing Address - Fax:330-645-1524
Practice Address - Street 1:2818 S ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-4716
Practice Address - Country:US
Practice Address - Phone:330-645-0153
Practice Address - Fax:330-645-1524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0459803207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty