Provider Demographics
NPI:1962698951
Name:DOCTORS OHIO HEALTH CORPORATION
Entity type:Organization
Organization Name:DOCTORS OHIO HEALTH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONAL DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:TI LYNN
Authorized Official - Middle Name:N
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-544-0167
Mailing Address - Street 1:2030 STRINGTOWN RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-3993
Mailing Address - Country:US
Mailing Address - Phone:614-544-0167
Mailing Address - Fax:614-544-0176
Practice Address - Street 1:2030 STRINGTOWN RD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-3993
Practice Address - Country:US
Practice Address - Phone:614-544-0167
Practice Address - Fax:614-544-0176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2639827Medicaid
OH2158203Medicaid
OHCB0331OtherRR MEDICARE
OH2201834Medicaid
OH2639729Medicaid
OH9364211Medicare PIN