Healthcare Provider Details

I. General information

NPI: 1699650036
Provider Name (Legal Business Name): MR. ERIC WOHLFORD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5475 RINGS RD
DUBLIN OH
43017-7537
US

IV. Provider business mailing address

2516 CRESTVIEW WOODS DR
NEWARK OH
43055-9280
US

V. Phone/Fax

Practice location:
  • Phone: 614-210-1885
  • Fax:
Mailing address:
  • Phone: 740-403-8954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number427776
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code243U00000X
TaxonomyRadiology Practitioner Assistant
License Number68.000029
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: