Healthcare Provider Details

I. General information

NPI: 1821083528
Provider Name (Legal Business Name): THOMAS A ROSSI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 01/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6905 HOSPITAL DR SUITE 120
DUBLIN OH
43016-9600
US

IV. Provider business mailing address

PO BOX 636365
CINCINNATI OH
45263-9600
US

V. Phone/Fax

Practice location:
  • Phone: 614-792-3767
  • Fax: 614-792-3768
Mailing address:
  • Phone: 614-792-3767
  • Fax: 614-792-3768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number35064049
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: