Provider Demographics
NPI:1952385221
Name:WEST CENTRAL OHIO GROUP LTD.
Entity Type:Organization
Organization Name:WEST CENTRAL OHIO GROUP LTD.
Other - Org Name:DBA INSTITUTE FOR ORTHOPAEDIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-224-7586
Mailing Address - Street 1:801 MEDICAL DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-4099
Mailing Address - Country:US
Mailing Address - Phone:419-224-7586
Mailing Address - Fax:419-224-9769
Practice Address - Street 1:801 MEDICAL DR
Practice Address - Street 2:SUITE B
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-4099
Practice Address - Country:US
Practice Address - Phone:419-224-7586
Practice Address - Fax:419-224-9769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-01
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1445282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000262164OtherANTHEM BLUE CROSS
OH2381177Medicaid
OH000000262164OtherANTHEM BLUE CROSS
ND=========OtherCOMMERCIAL
OH2381177Medicaid
OH2381177Medicaid