Healthcare Provider Details

I. General information

NPI: 1386418739
Provider Name (Legal Business Name): ASHOK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 FULTON ST
PORT CLINTON OH
43452-2001
US

IV. Provider business mailing address

7652 SAWMILL RD # 338
DUBLIN OH
43016-9296
US

V. Phone/Fax

Practice location:
  • Phone: 702-453-3799
  • Fax: 702-453-5741
Mailing address:
  • Phone: 702-453-3799
  • Fax: 702-453-5741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: VARUN ASHOK
Title or Position: OWNER / PROVIDER
Credential: M.D.
Phone: 404-353-4527