Provider Demographics
NPI:1306294947
Name:BRIAN R. CAIN, M.D. AND ASSOCIATES
Entity type:Organization
Organization Name:BRIAN R. CAIN, M.D. AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-351-2873
Mailing Address - Street 1:500 N PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:HARTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44632-9318
Mailing Address - Country:US
Mailing Address - Phone:330-877-3008
Mailing Address - Fax:330-877-3032
Practice Address - Street 1:754 S CLEVELAND AVE STE 300
Practice Address - Street 2:
Practice Address - City:MOGADORE
Practice Address - State:OH
Practice Address - Zip Code:44260-2210
Practice Address - Country:US
Practice Address - Phone:330-877-3008
Practice Address - Fax:330-877-3032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35061748261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care