Healthcare Provider Details

I. General information

NPI: 1487657342
Provider Name (Legal Business Name): JAMES EDWARD SILONE JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 11/24/2020
Certification Date: 11/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 W MAIN ST STE 100
NEWARK OH
43055-1385
US

IV. Provider business mailing address

1717 WEST MAIN ST., SUITE 100
NEWARK OH
43055-3681
US

V. Phone/Fax

Practice location:
  • Phone: 740-522-8555
  • Fax: 740-522-3620
Mailing address:
  • Phone: 740-522-8555
  • Fax: 740-522-3620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number34006821S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: