Provider Demographics
NPI:1992890461
Name:BARIATRIC SPECIALISTS OF OHIO
Entity type:Organization
Organization Name:BARIATRIC SPECIALISTS OF OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUDERER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-834-6802
Mailing Address - Street 1:3964 HAMILTON SQUARE BLVD.
Mailing Address - Street 2:
Mailing Address - City:GROVEPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43125-9119
Mailing Address - Country:US
Mailing Address - Phone:614-834-6980
Mailing Address - Fax:614-834-6950
Practice Address - Street 1:3964 HAMILTON SQUARE BLVD.
Practice Address - Street 2:
Practice Address - City:GROVEPORT
Practice Address - State:OH
Practice Address - Zip Code:43125-9119
Practice Address - Country:US
Practice Address - Phone:614-834-6980
Practice Address - Fax:614-834-6950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty