Provider Demographics
NPI:1215993381
Name:AKRON PATHOLOGY ASSOC INC
Entity type:Organization
Organization Name:AKRON PATHOLOGY ASSOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:SPEAKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:3303-344-7611
Mailing Address - Street 1:30701 LORAIN RD STE A
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-6325
Mailing Address - Country:US
Mailing Address - Phone:440-274-5000
Mailing Address - Fax:440-716-8608
Practice Address - Street 1:400 WABASH AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307
Practice Address - Country:US
Practice Address - Phone:330-344-7611
Practice Address - Fax:330-344-6418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0206870200OtherFEDERAL BLACK LUNG
OH0847703Medicaid
128075600OtherUNITED DEPARTMENT OF LABOR
128075600OtherUNITED DEPARTMENT OF LABOR
OH=========00OtherBUREAU OF WORKERS COMPENSATION
OH0847703Medicaid
OH0847703Medicaid
128075600OtherUNITED DEPARTMENT OF LABOR