Provider Demographics
NPI:1487711503
Name:CENTRAL OHIO SURGICAL GROUP, LLC
Entity type:Organization
Organization Name:CENTRAL OHIO SURGICAL GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:TROYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-734-5000
Mailing Address - Street 1:4995 BRADENTON AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-3543
Mailing Address - Country:US
Mailing Address - Phone:614-734-5000
Mailing Address - Fax:614-734-5001
Practice Address - Street 1:4995 BRADENTON AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-3543
Practice Address - Country:US
Practice Address - Phone:614-734-5000
Practice Address - Fax:614-734-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty