Healthcare Provider Details

I. General information

NPI: 1609845064
Provider Name (Legal Business Name): WEST OHIO X-RAY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SAINT CLAIR AVE
SAINT MARYS OH
45885-2400
US

IV. Provider business mailing address

PO BOX 5156
LIMA OH
45802-5156
US

V. Phone/Fax

Practice location:
  • Phone: 419-394-3335
  • Fax:
Mailing address:
  • Phone: 419-224-5707
  • Fax: 419-229-0040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: SEETARAM RAVIPATI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 419-238-2390