Provider Demographics
NPI:1720157381
Name:OHIO EAR INSTITUTE LLC
Entity Type:Organization
Organization Name:OHIO EAR INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RYZENMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-891-9190
Mailing Address - Street 1:387 COUNTY LINE ROAD WEST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-6077
Mailing Address - Country:US
Mailing Address - Phone:614-891-9190
Mailing Address - Fax:614-839-9174
Practice Address - Street 1:387 COUNTY LINE ROAD WEST
Practice Address - Street 2:SUITE 115
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-6077
Practice Address - Country:US
Practice Address - Phone:614-891-9190
Practice Address - Fax:614-839-9174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35088358207YX0901X
261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & NeurotologyGroup - Multi-Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2674566Medicaid