Healthcare Provider Details

I. General information

NPI: 1528208014
Provider Name (Legal Business Name): MID OHIO ONCOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2009
Last Update Date: 02/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N PICKAWAY ST
CIRCLEVILLE OH
43113-1447
US

IV. Provider business mailing address

3100 PLAZA PROPERTIES BLVD
COLUMBUS OH
43219-1531
US

V. Phone/Fax

Practice location:
  • Phone: 740-474-2126
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: TONIA BATEMAN
Title or Position: BUSINESS MANAGER
Credential:
Phone: 614-383-6224