Provider Demographics
NPI:1134479736
Name:JOG, AASHISH VILAS (MD)
Entity Type:Individual
Prefix:
First Name:AASHISH
Middle Name:VILAS
Last Name:JOG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 JOHNSON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2356
Mailing Address - Country:US
Mailing Address - Phone:740-283-2062
Mailing Address - Fax:740-283-2049
Practice Address - Street 1:4100 JOHNSON RD STE 102
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2356
Practice Address - Country:US
Practice Address - Phone:740-283-2062
Practice Address - Fax:740-283-2049
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT201805207XX0005X
OH35.130276207X00000X, 207XX0004X
PAMD449760207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0213546Medicaid