Healthcare Provider Details

I. General information

NPI: 1679528962
Provider Name (Legal Business Name): SURGICAL ASSOCIATES OF SOUTHWEST OHIO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 AUBURN AVE
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

1544 SOLUTIONS CTR
CHICAGO IL
60677-1005
US

V. Phone/Fax

Practice location:
  • Phone: 513-572-8720
  • Fax:
Mailing address:
  • Phone: 513-891-2813
  • Fax: 513-793-1032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JAY LOGEMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 513-791-1224