Provider Demographics
NPI:1235167826
Name:PRIZANT, RONALD J (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:J
Last Name:PRIZANT
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:PO BOX 182255
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43218-2255
Mailing Address - Country:US
Mailing Address - Phone:614-430-5724
Mailing Address - Fax:
Practice Address - Street 1:6505 MARKET STREET SUITE #101
Practice Address - Street 2:THE ORTHOPEDIC SURGERY CENTER C/O EZ ANESTHESIA, LLC
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-5623
Practice Address - Country:US
Practice Address - Phone:330-758-1065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35059771207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0797973Medicaid
PA01644657Medicaid
000000139894OtherANTHEM
050045166OtherMEDICARE RAILROAD
PR0672262Medicare ID - Type Unspecified
OH0797973Medicaid