Provider Demographics
NPI:1609094226
Name:CIOS, JACQUELYNE SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELYNE
Middle Name:SUSAN
Last Name:CIOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD
Mailing Address - Street 2:SUITE 570
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-6526
Mailing Address - Fax:614-293-3555
Practice Address - Street 1:2050 KENNY RD
Practice Address - Street 2:7TH FLOOR
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-3502
Practice Address - Country:US
Practice Address - Phone:614-293-6526
Practice Address - Fax:614-293-3555
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2013-04-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH350908992084N0400X, 2084N0600X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3111386Medicaid
OH3111386Medicaid