Provider Demographics
NPI:1679028799
Name:SOUTH CENTRAL OHIO ANESTHESIA, LLC
Entity Type:Organization
Organization Name:SOUTH CENTRAL OHIO ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:VEITH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:614-578-5334
Mailing Address - Street 1:PO BOX 636775
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6775
Mailing Address - Country:US
Mailing Address - Phone:859-291-4800
Mailing Address - Fax:859-655-8588
Practice Address - Street 1:8885 STATE ROAD 237
Practice Address - Street 2:
Practice Address - City:TELL CITY
Practice Address - State:IN
Practice Address - Zip Code:47586-8567
Practice Address - Country:US
Practice Address - Phone:614-578-5334
Practice Address - Fax:859-655-8588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28152064A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty