Healthcare Provider Details

I. General information

NPI: 1700913704
Provider Name (Legal Business Name): PHYSICIANS CHOICE FIRST ASSISTING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 STONESTHROW CT
ALEXANDRIA OH
43001-8779
US

IV. Provider business mailing address

55 STONESTHROW CT
ALEXANDRIA OH
43001-8779
US

V. Phone/Fax

Practice location:
  • Phone: 614-402-1869
  • Fax: 888-329-6432
Mailing address:
  • Phone: 614-402-1869
  • Fax: 888-329-6432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number StateOH

VIII. Authorized Official

Name: COLE D STATEN
Title or Position: PRESIDENT
Credential: CST/CSFA
Phone: 614-402-1869