Provider Demographics
NPI:1558739862
Name:OHIOHEALTH NEUROLOGICAL PHISICIANS
Entity Type:Organization
Organization Name:OHIOHEALTH NEUROLOGICAL PHISICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-544-6210
Mailing Address - Street 1:5400 FRANTZ RD
Mailing Address - Street 2:250
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4144
Mailing Address - Country:US
Mailing Address - Phone:614-544-6210
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:3555 OLENTANGY RIVER RD
Practice Address - Street 2:2002
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3912
Practice Address - Country:US
Practice Address - Phone:614-788-2450
Practice Address - Fax:614-788-2494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty