Healthcare Provider Details

I. General information

NPI: 1720165293
Provider Name (Legal Business Name): REGIONAL MEDICAL ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5131 BEACON HILL RD SUITE 200
COLUMBUS OH
43228-4442
US

IV. Provider business mailing address

5131 BEACON HILL RD SUITE 200
COLUMBUS OH
43228-4442
US

V. Phone/Fax

Practice location:
  • Phone: 614-851-5430
  • Fax: 614-851-5449
Mailing address:
  • Phone: 614-851-5430
  • Fax: 614-851-5449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number34002304
License Number StateOH

VIII. Authorized Official

Name: THEODORE W POLLOCK
Title or Position: PRESIDENT
Credential: D.O.
Phone: 614-851-5430