Healthcare Provider Details

I. General information

NPI: 1467717553
Provider Name (Legal Business Name): OHIO ONCOLOGY & HEMATOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 07/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 JASONWAY AVE
COLUMBUS OH
43214-4359
US

IV. Provider business mailing address

PO BOX 361166
COLUMBUS OH
43236-1166
US

V. Phone/Fax

Practice location:
  • Phone: 614-442-3130
  • Fax:
Mailing address:
  • Phone: 614-383-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number2103547
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number2103547
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number2103547
License Number StateOH

VIII. Authorized Official

Name: DR. PATRICK C ELWOOD
Title or Position: PRESIDENT
Credential: MD
Phone: 614-383-6000