Provider Demographics
NPI:1730204942
Name:COMPREHENSIVE PEDIATRICS INC
Entity type:Organization
Organization Name:COMPREHENSIVE PEDIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS VP
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SEBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-871-5100
Mailing Address - Street 1:2001 CROCKER RD
Mailing Address - Street 2:600
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-6966
Mailing Address - Country:US
Mailing Address - Phone:440-871-5100
Mailing Address - Fax:440-871-5610
Practice Address - Street 1:2001 CROCKER RD
Practice Address - Street 2:600
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-6966
Practice Address - Country:US
Practice Address - Phone:440-871-5100
Practice Address - Fax:440-871-5610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty