Healthcare Provider Details

I. General information

NPI: 1881690642
Provider Name (Legal Business Name): WILLIAM J SOMERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 01/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 OLENTANGY RIVER RD SUITE 3080
COLUMBUS OH
43214-3912
US

IV. Provider business mailing address

3555 OLENTANGY RIVER RD SUITE3080
COLUMBUS OH
43214-3912
US

V. Phone/Fax

Practice location:
  • Phone: 614-268-6000
  • Fax: 614-267-1879
Mailing address:
  • Phone: 614-268-6000
  • Fax: 614-267-1879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number35060840S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: