Healthcare Provider Details

I. General information

NPI: 1841326543
Provider Name (Legal Business Name): CENTRAL OHIO ONCOLOGY, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
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

6670 PERIMETER DR
DUBLIN OH
43017
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 Code207RX0202X
TaxonomyMedical Oncology Physician
License Number34-00-2304
License Number StateOH

VIII. Authorized Official

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