Provider Demographics
NPI:1700819547
Name:OHIO NEUROSURGICAL INSTITUTE INC
Entity Type:Organization
Organization Name:OHIO NEUROSURGICAL INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-208-4812
Mailing Address - Street 1:30 E APPLE ST
Mailing Address - Street 2:SUITE 6254
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2939
Mailing Address - Country:US
Mailing Address - Phone:937-208-2780
Mailing Address - Fax:937-208-2898
Practice Address - Street 1:30 E APPLE ST
Practice Address - Street 2:SUITE 6254
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2939
Practice Address - Country:US
Practice Address - Phone:937-208-2780
Practice Address - Fax:937-208-2898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2536125Medicaid
OH2544714Medicaid
OH2544698Medicaid
OH2544643Medicaid
OH2544625Medicaid
OH2544661Medicaid
OH2544705Medicaid
OH2147742Medicaid
OH2544723Medicaid
OH2544698Medicaid
OH9306713Medicare PIN
OH2544643Medicaid
OH2147742Medicaid
OH2536125Medicaid
OH2544625Medicaid