Provider Demographics
NPI:1376509661
Name:MID OHIO ONCOLOGY HEMATOLOGY INC
Entity Type:Organization
Organization Name:MID OHIO ONCOLOGY HEMATOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ELWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-383-6000
Mailing Address - Street 1:3100 PLAZA PROPERTIES BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-1530
Mailing Address - Country:US
Mailing Address - Phone:614-383-6000
Mailing Address - Fax:614-383-6001
Practice Address - Street 1:3100 PLAZA PROPERTIES BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-1530
Practice Address - Country:US
Practice Address - Phone:614-383-6000
Practice Address - Fax:614-383-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35046723174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0606713Medicaid
3676155OtherNCPDP
OH5292790005Medicare NSC
OH0606713Medicaid