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General NPI Number Information
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NPI Number | 1730381369
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Entity Type | Organization
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Legal Business Name | NORTH CENTRAL OHIO EAR NOSE & THROAT SURGEONS INC
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 04/18/2022
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Provider Practice Location Address
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Address Line | 3540 BURBANK RD # 108
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City | WOOSTER
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State | OH
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Zip | 44691-8539
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Country | US
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Telephone | 330-621-8013
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Fax | 330-682-2115
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Provider Business Mailing Address
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Address Line | 3540 BURBANK RD # 108
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City | WOOSTER
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State | OH
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Zip | 44691-8539
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Country | US
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Telephone | 330-621-8013
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Fax | 330-682-2115
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC R GRIMES
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Credential | MD
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Telephone | 419-566-7198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 35086045
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License Number State | OH
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