Provider Demographics
NPI:1619957933
Name:ASSOCIATED PATHOLOGISTS, INC.
Entity Type:Organization
Organization Name:ASSOCIATED PATHOLOGISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT- ASSOCIATED PATHOLOGISTS,
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOLDYS COVENEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-698-9711
Mailing Address - Street 1:PO BOX 1188
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-1188
Mailing Address - Country:US
Mailing Address - Phone:419-696-7200
Mailing Address - Fax:419-698-2841
Practice Address - Street 1:715 S COY RD
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3007
Practice Address - Country:US
Practice Address - Phone:419-698-9711
Practice Address - Fax:419-698-2841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-20
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0484300Medicaid
OH0484300Medicaid