Provider Demographics
NPI:1760649446
Name:PHYSICIAN CENTER OF DUBLIN INC
Entity Type:Organization
Organization Name:PHYSICIAN CENTER OF DUBLIN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:B
Authorized Official - Last Name:MISCHLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-923-8400
Mailing Address - Street 1:4351 DALE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-5403
Mailing Address - Country:US
Mailing Address - Phone:614-923-8400
Mailing Address - Fax:614-923-8401
Practice Address - Street 1:4351 DALE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-5403
Practice Address - Country:US
Practice Address - Phone:614-923-8400
Practice Address - Fax:614-923-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9307841Medicare PIN