MEDICARE: OHIOHEALTH CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952600074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIOHEALTH CORPORATION

Provider Business Mailing Address
First Line	:	5350 FRANTZ RD
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43016-4259
Country	:	US
Telephone Number	:	614-544-6356
Fax Number	:	614-544-6370

Provider Business Practice Location Address
First Line	:	5141 W BROAD ST STE 150
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43228-1984
Country	:	US
Telephone Number	:	614-544-1860
Fax Number	:	614-544-1870

Authorized Official
Title or Position	:	DIRECTOR OF REVENUE CYCLE
Name	:	MARK WUESTEWALD
Credential	:
Telephone Number	:	614-544-6351

Provider Enumeration Date	:	03/16/2011
Last Update Date	:	03/16/2011

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Directions to “OHIOHEALTH CORPORATION ” Practice Location

Language	Start Address	Practice Location

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