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General NPI Number Information
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NPI Number | 1063514107
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Entity Type | Organization
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Legal Business Name | OHIO SURGERY CENTER LLC
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 12/04/2012
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Provider Practice Location Address
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Address Line | 930 BETHEL RD
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City | COLUMBUS
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State | OH
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Zip | 43214-1906
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Country | US
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Telephone | 614-451-0500
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Fax | 614-451-2844
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Provider Business Mailing Address
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Address Line | 930 BETHEL RD
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City | COLUMBUS
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State | OH
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Zip | 43214-1906
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Country | US
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Telephone | 614-451-0500
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Fax | 614-451-2844
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Authorized Official
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Title or Position | CHARIMAN OF THE BOARD
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Name | DR. MICHAEL D MARTYN
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Credential | M.D.
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Telephone | 614-451-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 386
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License Number State | OH
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