Provider Demographics
NPI:1609032275
Name:GENERAL PRACTICE ASSOCIATES, INC
Entity Type:Organization
Organization Name:GENERAL PRACTICE ASSOCIATES, INC
Other - Org Name:JOHN H GULUZIAN D O
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-443-8155
Mailing Address - Street 1:1201 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-3400
Mailing Address - Country:US
Mailing Address - Phone:614-443-8155
Mailing Address - Fax:614-443-8090
Practice Address - Street 1:1201 S HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-3400
Practice Address - Country:US
Practice Address - Phone:614-443-8155
Practice Address - Fax:614-443-8090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-2755G207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH18542586900OtherBWC
OH0375268Medicaid
OH18542586900OtherBWC
D89539Medicare UPIN