Connor Mortimer
Physician Assistant in Lima, OH. Individual provider (NPI-1).
NPI number1164084802
StatusActive
Last updated in NPPESJan 20, 2021
Details
- NPI
- 1164084802
- Entity type
- Individual (NPI-1)
- Name
- Connor Mortimer
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 2, 2019
- Certification date
- Jan 20, 2021
- Last updated
- Jan 20, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 50.006693RX | OH | Yes |
Practice location
730 W Market St Ste 2kLima, OH 45801-4602
Phone 419-996-5852 · Fax 419-996-5854
Mailing address
2636 N Moreland Blvd Apt 21Cleveland, OH 44120-1466
Phone 419-979-8592
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