Healthcare Provider Details

I. General information

NPI: 1720157381
Provider Name (Legal Business Name): OHIO EAR INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 01/10/2020
Certification Date: 01/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

387 COUNTY LINE ROAD WEST SUITE 115
WESTERVILLE OH
43082-6077
US

IV. Provider business mailing address

387 COUNTY LINE ROAD WEST SUITE 115
WESTERVILLE OH
43082-6077
US

V. Phone/Fax

Practice location:
  • Phone: 614-891-9190
  • Fax: 614-839-9174
Mailing address:
  • Phone: 614-891-9190
  • Fax: 614-839-9174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number35088358
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN M RYZENMAN
Title or Position: DIRECTOR
Credential: MD
Phone: 614-891-9190