Healthcare Provider Details

I. General information

NPI: 1891102489
Provider Name (Legal Business Name): SETH VENSIL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2014
Last Update Date: 07/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 ASHLAND AVE
ZANESVILLE OH
43701-2806
US

IV. Provider business mailing address

1246 ASHLAND AVE SUITE 204
ZANESVILLE OH
43701-2861
US

V. Phone/Fax

Practice location:
  • Phone: 740-454-8551
  • Fax: 740-454-2411
Mailing address:
  • Phone: 740-450-6147
  • Fax: 740-450-6157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.128342
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: