Healthcare Provider Details

I. General information

NPI: 1023090073
Provider Name (Legal Business Name): CURT A MISKO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 02/01/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 MESSIMER DR
NEWARK OH
43055-1841
US

IV. Provider business mailing address

1320 W MAIN ST
NEWARK OH
43055-1822
US

V. Phone/Fax

Practice location:
  • Phone: 220-564-4677
  • Fax: 220-564-4678
Mailing address:
  • Phone: 220-564-4027
  • Fax: 220-564-4012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number35.142244
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD185822
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number069079
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number01081527A
License Number StateIN
# 5
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35.142244
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: