Healthcare Provider Details

I. General information

NPI: 1720061229
Provider Name (Legal Business Name): ATTILA POKA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 E STATE ST STE 500
COLUMBUS OH
43215-4354
US

IV. Provider business mailing address

1299 OLENTANGY RIVER RD STE 103
COLUMBUS OH
43212-3135
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-7777
  • Fax: 614-566-8880
Mailing address:
  • Phone: 614-566-4278
  • Fax: 614-566-5424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number064124 (O)
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: