Provider Demographics
NPI:1023129822
Name:ONCOLOGY HEMATOLOGY CONSULTANTS OF SOUTHEASTERN OHIO, INC
Entity type:Organization
Organization Name:ONCOLOGY HEMATOLOGY CONSULTANTS OF SOUTHEASTERN OHIO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:UTPAL
Authorized Official - Middle Name:K
Authorized Official - Last Name:BHANJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-455-8506
Mailing Address - Street 1:751 FOREST AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2875
Mailing Address - Country:US
Mailing Address - Phone:740-455-8506
Mailing Address - Fax:740-455-8509
Practice Address - Street 1:751 FOREST AVENUE
Practice Address - Street 2:SUITE 201
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2875
Practice Address - Country:US
Practice Address - Phone:740-455-8506
Practice Address - Fax:740-455-8509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2462473Medicaid
OH2462473Medicaid
OH9337921Medicare PIN