Provider Demographics
NPI:1538177183
Name:WEST CENTRAL OHIO CARDIOLOGY INC
Entity type:Organization
Organization Name:WEST CENTRAL OHIO CARDIOLOGY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:WOLERY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-222-3828
Mailing Address - Street 1:770 W HIGH ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-3990
Mailing Address - Country:US
Mailing Address - Phone:419-222-3828
Mailing Address - Fax:419-224-5394
Practice Address - Street 1:770 W HIGH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-3990
Practice Address - Country:US
Practice Address - Phone:419-222-3828
Practice Address - Fax:419-224-5394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35046616207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5734614OtherAETNA
OH2070842Medicaid
OH2070842Medicaid
OH5734614OtherAETNA
OH=========8A00OtherANTHEM