Healthcare Provider Details

I. General information

NPI: 1669794152
Provider Name (Legal Business Name): SOUND INPATIENT PHYSICIANS OF OHIO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2010
Last Update Date: 02/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 SCIOTO ST
URBANA OH
43078-2226
US

IV. Provider business mailing address

PO BOX 60000 FILE 31223
SAN FRANCISCO CA
94160-0001
US

V. Phone/Fax

Practice location:
  • Phone: 937-653-5231
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES KODJABABIAN
Title or Position: CRO
Credential:
Phone: 253-682-1710