Provider Demographics
NPI:1528006582
Name:VASSY, LOUIS E (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:E
Last Name:VASSY
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 1:5350 FRANTZ RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4259
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4882 E MAIN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-3189
Practice Address - Country:US
Practice Address - Phone:614-566-0774
Practice Address - Fax:614-566-0762
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35030189208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0258779Medicaid
OHE75362Medicare UPIN
OH0405623Medicare PIN