Provider Demographics
NPI:1649536723
Name:POLLOCK, EKS WYE IV (MD)
Entity type:Individual
Prefix:DR
First Name:EKS
Middle Name:WYE
Last Name:POLLOCK
Suffix:IV
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 1:700 CHILDREN'S DR - ED650A
Mailing Address - Street 2:OSU/NCH INTERNAL MEDICINE-PEDIATRIC RESIDENCY PROGRAM
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205
Mailing Address - Country:US
Mailing Address - Phone:614-722-0417
Mailing Address - Fax:614-722-6132
Practice Address - Street 1:6767 29TH ST FL 3
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-5474
Practice Address - Country:US
Practice Address - Phone:970-221-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.021051207R00000X, 208000000X
CODR.0061661207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics