Provider Demographics
NPI:1154823953
Name:BUCKEYE CLINIC
Entity Type:Organization
Organization Name:BUCKEYE CLINIC
Other - Org Name:BUCKEYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:
Authorized Official - Last Name:SINHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-792-6242
Mailing Address - Street 1:6805 AVERY MUIRFIELD DR STE 103
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-7182
Mailing Address - Country:US
Mailing Address - Phone:614-534-1100
Mailing Address - Fax:
Practice Address - Street 1:6805 AVERY MUIRFIELD DR STE 103
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-7182
Practice Address - Country:US
Practice Address - Phone:614-534-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory