Provider Demographics
NPI:1790734119
Name:RIZZO, JOSEPH J (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:RIZZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:L-3549
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43260-0001
Mailing Address - Country:US
Mailing Address - Phone:740-383-7927
Mailing Address - Fax:740-383-7942
Practice Address - Street 1:1040 DELAWARE AVENUE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43301-1814
Practice Address - Country:US
Practice Address - Phone:740-383-8080
Practice Address - Fax:740-383-8084
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35050590207V00000X
OH35.050590207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
160017771OtherTRAVELERS MEDICARE
OH000000118377OtherANTHEM
0700451OtherUHC
353077OtherSUBMITTER NO.
0639681OtherPALMETTO MEDICARE
646769OtherAETNA
OH0556778Medicaid
160017771OtherTRAVELERS MEDICARE
OH0639681Medicare ID - Type Unspecified
OHH161620Medicare PIN
646769OtherAETNA
OH0639681Medicare ID - Type Unspecified
353077OtherSUBMITTER NO.