MEDICARE: DR. JAMES W. ROCCO M.D.,PHD

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	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	161152	MA
2	207Y00000X	Otolaryngology Physician	35125186	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972594091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES W. ROCCO M.D.,PHD

Provider Business Mailing Address
First Line	:	915 OLENTANGY RIVER RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-3153
Country	:	US
Telephone Number	:	614-366-3687
Fax Number	:	614-293-7292

Provider Business Practice Location Address
First Line	:	915 OLENTANGY RIVER RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-3153
Country	:	US
Telephone Number	:	614-366-3687
Fax Number	:	614-293-7292

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	12/29/2014

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