Provider Demographics
NPI:1720007875
Name:RINKOV, MARK HOWARD (OD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:HOWARD
Last Name:RINKOV
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 E GAY STREET
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-3103
Mailing Address - Country:US
Mailing Address - Phone:614-224-2414
Mailing Address - Fax:614-224-5916
Practice Address - Street 1:81 E GAY STREET
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-3103
Practice Address - Country:US
Practice Address - Phone:614-224-2414
Practice Address - Fax:614-224-5916
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3085152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0214780Medicaid
T46913Medicare UPIN
OHRI0441957Medicare ID - Type Unspecified