Provider Demographics
NPI:1295927283
Name:OSU OTOLARYNGOLOGY-HEAD AND NECK SURGERY
Entity type:Organization
Organization Name:OSU OTOLARYNGOLOGY-HEAD AND NECK SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:INMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-293-3470
Mailing Address - Street 1:565 METRO PL S
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-5351
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:565 METRO PL S
Practice Address - Street 2:SUITE 400
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-5351
Practice Address - Country:US
Practice Address - Phone:614-293-8150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech