MEDICARE: SOUTHEAST OHIO REGIONAL ORTHOPAEDIC CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	35053038	OH

General Provider Information

NPI Number	:	1952691248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHEAST OHIO REGIONAL ORTHOPAEDIC CENTER LLC

Provider Business Mailing Address
First Line	:	2682 KULL RD
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-7707
Country	:	US
Telephone Number	:	740-687-3394
Fax Number	:	614-834-6927

Provider Business Practice Location Address
First Line	:	2682 KULL RD
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-7707
Country	:	US
Telephone Number	:	740-687-3394
Fax Number	:	614-834-6927

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEPHEN J VOTO
Credential	:	M.D.
Telephone Number	:	740-687-3394

Provider Enumeration Date	:	04/08/2011
Last Update Date	:	12/19/2011

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