Provider Demographics
NPI:1780994970
Name:CENTRAL OHIO SURGICAL ASSOCIATES
Entity type:Organization
Organization Name:CENTRAL OHIO SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:H
Authorized Official - Last Name:DABBS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-864-6363
Mailing Address - Street 1:6075 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-5131
Mailing Address - Country:US
Mailing Address - Phone:614-866-4270
Mailing Address - Fax:614-866-4271
Practice Address - Street 1:6075 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-5131
Practice Address - Country:US
Practice Address - Phone:614-864-6363
Practice Address - Fax:614-864-2248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35065404174400000X
OH35071465174400000X
OH35090887174400000X
OH35031737174400000X
OH35048045174400000X
OH35073587174400000X
OH3504425174400000X
OH35076919174400000X
OH35077376174400000X
OH35062200174400000X
OH35061825174400000X
208200000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCH4167071Medicare PIN
OHPR0769112Medicare PIN
OHKE0896181Medicare PIN
OHTU0819371Medicare PIN
VA0588444Medicare PIN
OHBU0391312Medicare PIN
OHCH0698346Medicare PIN
OHZO4107701Medicare PIN
OHSI0725001Medicare PIN
OHMI4104871Medicare PIN
OHKR4240441Medicare PIN
OHHA0513483Medicare PIN