DR. ROBERT EDWIN EXTEN JR.


Address: 475 Lexington Ave, Mansfield, OH 44907-1501
Phone: 4197562003

DR. ROBERT EDWIN EXTEN JR. (NPI# 1205832375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1205832375
Entity Type Individual
Full Name DR. ROBERT EDWIN EXTEN JR.
Credential MD
Practice Address 475 Lexington Ave
Mansfield
OH 44907-1501
Practice Telephone 4197562003
Practice Fax Number 4197563637
Mailing Telephone 4197562003
Mailing Fax Number 4197563637
Enumeration Date 2005-06-23
Last Update Date 2010-01-26
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RH0003X Internal Medicine
Specialization: Hematology & Oncology
35038459E OH Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
OH 0519460 05
OH MEDICARE RAILRROAD 830006430 01
OH ANTHEM 000000142119 01

Office Location

Street Address 475 LEXINGTON AVE
City MANSFIELD
State OH
Zip Code 44907-1501

Providers in the same location

NPI Name Taxonomy Address Enumeration
1528687589 Lorrie L. Hedrick Counselor 475 Lexington Ave, Mansfield, OH 44907-1501 2020-04-10
1164041125 Alissa R Keysor Licensed Practical Nurse 475 Lexington Ave, Mansfield, OH 44907-1501 2020-04-10
1013579234 Shaunqua S Crawford Licensed Practical Nurse 475 Lexington Ave, Mansfield, OH 44907-1501 2019-07-09
1184053100 Tammy Canfield Nurse Practitioner 475 Lexington Ave, Mansfield, OH 44907-1501 2013-11-12
1821148404 Woodside Medical Group, Inc. Clinic/Center 475 Lexington Ave, Mansfield, OH 44907-1501 2007-01-12

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1053932434 Kerri Nichole Tolliver Licensed Practical Nurse Mansfield Comprehensive Treatment Center, 475 Lexington Ave, Mansfield, OH 44907 2020-04-27
1790325371 Gabrielle Smith Licensed Practical Nurse 707 Scholl Rd, Mansfield, OH 44907 2020-01-10
1912544982 Heidi L Mathews Behavior Technician 270 Sterkel Blvd., Mansfield, OH 44907 2019-12-09
1851942254 Misty J Kline Licensed Practical Nurse 707 Scholl Rd., Mansfield, OH 44907 2019-09-26
1528533320 Ohio Treatment Center, LLC Clinic/Center 475 Lexington Ave., Mansfield, OH 44907 2018-10-08
1750898722 Hannah Rose Hardin Behavior Technician 1033 Larchwood R, Mansfield, OH 44907 2017-12-29
1932548856 Jessica Alexis Taylor Counselor 641 Scholl Rd., Mansfield, OH 44907 2013-06-25
1336495258 Sonal Sinha Psychiatry & Neurology 341 Cline Ave Ste 1, Mansfield, OH 44907 2012-07-29
1427321579 Tara Kightlinger Community Health Worker 442 Brenda Dr, Mansfield, OH 44907 2012-02-21
1649557620 William Scott Olar Chiropractor 1179 Lexington Ave, Mansfield, OH 44907 2011-11-04
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Taxonomy Information

Taxonomy Code 207RH0003X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Hematology & Oncology

Taxonomy Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1538147525 Donald Lee Dewald Internal Medicine 1125 Aspira Ct, Mansfield, OH 44906-4125 2006-01-09
1952694739 Paula A. Mcbrine, M.d., P.C. Internal Medicine 205 Chauncy St, Mansfield, MA 02048-1202 2011-05-26
1700040490 Dallas Oncology Consultants Pa Internal Medicine 2800 E Broad St, Suite 212, Mansfield, TX 76063-6409 2008-07-11
1689644114 Shahzad M Khan Internal Medicine 1125 Aspira Ct, Mansfield, OH 44906-4125 2006-01-26
1972573848 Saurabh Das Internal Medicine 1125 Aspira Ct, Mansfield, OH 44906-4125 2006-01-24

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1013315076 Clermont County Cancer Center LLC Internal Medicine 4402 Hartman Ln, Batavia, OH 45103-1971 2014-12-08
1215353834 Ahmed M Ghany Internal Medicine 100 W 3rd Ave Ste 150, Columbus, OH 43201-3260 2014-03-06
1972935716 Stanley P Balcerzak Internal Medicine 3113 N 3 Bs and K Rd, Sunbury, OH 43074-9674 2013-08-03
1184056996 Mohammad Ansari-dezfuli Internal Medicine 1700 Carriage Place, Gates Mills, OH 44040 2013-08-02
1043569486 Virginia Ann Rhodes Internal Medicine 1557 Landsdale Cir, Twinsburg, OH 44087-3337 2012-08-30
1629324009 Earl Nelson Metz Internal Medicine 226 E. Dublin Granville Rd., Worthington, OH 43085-3185 2012-08-03
1366715260 John Kiess Kurtz Internal Medicine 3676 Kehrer Rd, Bucyrus, OH 44820-8624 2012-02-23
1922398049 Vamsi Koduri Internal Medicine 4435 State Route 159, Chillicothe, OH 45601 2011-04-11
1528392297 William H Sigalove Internal Medicine 130 Meadow Dr, Elyria, OH 44035-1838 2009-09-28
1922236017 Amir Iqbal Internal Medicine 885 S Sawburg Ave, Suite 110, Alliance, OH 44601-5926 2009-06-26
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Competitor

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City MANSFIELD
Zip Code 44907

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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