| Central Ohio Neurology Inc | |
|
370 Cline Avenue Ste C5 Mansfield OH 44907-1057 | |
| (419) 756-6990 | |
| (419) 756-0944 |
| Full Name | Central Ohio Neurology Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 370 Cline Avenue, Mansfield, Ohio |
| Authorized Official Name and Position | Raymond J Baddour (OWNER) |
| Authorized Official Contact | 4197566990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Ohio Neurology Inc 370 Cline Ave Ste C5 Mansfield OH 44907-1057 Ph: (419) 756-6990 | Central Ohio Neurology Inc 370 Cline Avenue Ste C5 Mansfield OH 44907-1057 Ph: (419) 756-6990 |
| NPI Number | 1619010535 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 08/27/2012 |
| Medicare PECOS PAC ID | 2163553595 |
|---|---|
| Medicare Enrollment ID | O20100629000815 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619010535 | NPI | - | NPPES |
| 2877801 | Medicaid | OH | |
| 606176800 | Other | OH | DEPT OF LABOR ID |
| 30022664 | Other | OH | RAILROAD MEDICARE |
| 000000182209 | Other | OH | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Raymond J Baddour |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508875634 PECOS PAC ID: 3971634304 Enrollment ID: I20100629000840 |
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