Provider Demographics
NPI:1912187626
Name:ULLOA, SERGIO AGNI (DO)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:AGNI
Last Name:ULLOA
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Gender:M
Credentials:DO
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Mailing Address - Street 1:5450 FRANTZ RD STE 360
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4141
Mailing Address - Country:US
Mailing Address - Phone:614-544-6155
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:75 HOSPITAL DR STE 140
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2858
Practice Address - Country:US
Practice Address - Phone:740-566-4720
Practice Address - Fax:740-566-4721
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2022-01-25
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Provider Licenses
StateLicense IDTaxonomies
OH34.009633207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery