Provider Demographics
NPI:1831226240
Name:TSUYOSHI INOSHITA MD INC
Entity type:Organization
Organization Name:TSUYOSHI INOSHITA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-353-4884
Mailing Address - Street 1:916 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-3411
Mailing Address - Country:US
Mailing Address - Phone:740-353-4884
Mailing Address - Fax:740-353-8798
Practice Address - Street 1:916 11TH ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3411
Practice Address - Country:US
Practice Address - Phone:740-353-4884
Practice Address - Fax:740-353-8798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35055111174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0824139Medicaid
OHF03052Medicare UPIN
OH0824139Medicaid