Healthcare Provider Details
I. General information
NPI: 1134046139
Provider Name (Legal Business Name): OHIO EAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1901 OHIO DR
GROVE CITY OH
43123-4835
US
IV. Provider business mailing address
840 W ALEX BELL RD
DAYTON OH
45459-3102
US
V. Phone/Fax
- Phone: 614-259-7451
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207YX0901X |
| Taxonomy | Otology & Neurotology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
PRUETER
Title or Position: PHYSICIAN
Credential: DO
Phone: 614-259-7451