Provider Demographics
NPI:1669439824
Name:GARSKE, JOHN P (PH D)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:GARSKE
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
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Mailing Address - Street 1:3086 STATE ROUTE 160
Mailing Address - Street 2:WOODLAND CENTERS INC
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-8409
Mailing Address - Country:US
Mailing Address - Phone:740-446-5500
Mailing Address - Fax:740-441-4402
Practice Address - Street 1:1 ACY AVENUE
Practice Address - Street 2:SUITE B WOODLAND CENTERS INC
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-0828
Practice Address - Country:US
Practice Address - Phone:740-286-5075
Practice Address - Fax:740-288-7335
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH1316103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0253701Medicaid
OH000000117253OtherANTHEM
OH0253701Medicaid