| Krishna M Ragothaman Md Inc | |
|
128 N Locust St Oak Harbor OH 43449-1358 | |
| (419) 898-8124 | |
| (419) 898-9148 |
| Full Name | Krishna M Ragothaman Md Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 128 N Locust St, Oak Harbor, Ohio |
| Authorized Official Name and Position | Krishna M Ragothaman (OWNER) |
| Authorized Official Contact | 4198988124 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Krishna M Ragothaman Md Inc Po Box 415 Oak Harbor OH 43449-0415 Ph: (419) 898-8124 | Krishna M Ragothaman Md Inc 128 N Locust St Oak Harbor OH 43449-1358 Ph: (419) 898-8124 |
| NPI Number | 1841561677 |
|---|---|
| Provider Enumeration Date | 01/25/2012 |
| Last Update Date | 01/25/2012 |
| Medicare PECOS PAC ID | 5496913444 |
|---|---|
| Medicare Enrollment ID | O20120221001094 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841561677 | NPI | - | NPPES |
| 01816465 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 35068996 R (Ohio) | Primary |
| Provider Name | Elizabeth A Musolf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003816869 PECOS PAC ID: 8123024973 Enrollment ID: I20061018000471 |
| Provider Name | Krishna Ragothaman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295738235 PECOS PAC ID: 9537127410 Enrollment ID: I20081205000202 |