Provider Demographics
NPI:1306958723
Name:CORNERSTONE OB-GYN, INC
Entity type:Organization
Organization Name:CORNERSTONE OB-GYN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, CMOM
Authorized Official - Phone:419-522-6800
Mailing Address - Street 1:770 BALGREEN DR
Mailing Address - Street 2:SUITE 207
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-4106
Mailing Address - Country:US
Mailing Address - Phone:419-522-6800
Mailing Address - Fax:419-522-6816
Practice Address - Street 1:770 BALGREEN DR
Practice Address - Street 2:SUITE 207
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-4106
Practice Address - Country:US
Practice Address - Phone:419-522-6800
Practice Address - Fax:419-522-6816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2313839Medicaid
OH2313839Medicaid