Provider Demographics
NPI:1194718049
Name:UCCI, JOHN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:UCCI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1104
Mailing Address - Country:US
Mailing Address - Phone:740-773-4366
Mailing Address - Fax:740-775-7855
Practice Address - Street 1:1049 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-1104
Practice Address - Country:US
Practice Address - Phone:740-773-4366
Practice Address - Fax:740-775-7855
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35084142U207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2467227Medicaid
311155352OtherNATIONWIDE INS.
0112393OtherUNITED HEALTHCARE
311155352OtherCENTRAL BENEFITS
311155352OtherAETNA
311155352OtherOHIO HEALTH CHOICE
311155352OtherE V BENEFITS
311155352OtherGREAT WEST
311155352OtherEMERALD HEALTH
OH000000332118OtherANTHEM
311155352OtherPPO NEXT
311155352OtherCIGNA/CONN. GEN.
311155352001OtherTRICARE
311155352OtherOHIO HEALTH CHOICE
311155352001OtherTRICARE
311155352OtherEMERALD HEALTH