Provider Demographics
NPI:1689691487
Name:CENTRAL OHIO PLASTIC SURGERY INC
Entity Type:Organization
Organization Name:CENTRAL OHIO PLASTIC SURGERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:740-653-5064
Mailing Address - Street 1:2656 N COLUMBUS ST STE A
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-8991
Mailing Address - Country:US
Mailing Address - Phone:740-653-5064
Mailing Address - Fax:740-653-6474
Practice Address - Street 1:2656 N COLUMBUS ST STE A
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8991
Practice Address - Country:US
Practice Address - Phone:740-653-5064
Practice Address - Fax:740-653-6474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCE9356091Medicare ID - Type UnspecifiedMEDICARE GROUP #