Active NPI
Medical Serices of Coshocton, Inc
- Surgery Physician
- Coshocton, OH
National Provider Identifier
1306886627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 35080169
- Legal business name
- MEDICAL SERICES OF COSHOCTON, INC
- Practice address
- 311 S 15TH St
Coshocton, OH 43812-1873 - Phone
- (740) 622-0799
- Fax
- (740) 622-0636
- NPI assigned
- Jun 7, 2006
- Last updated
- Jan 11, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert Miller
- Title
- Ceo
- Phone
- (740) 623-4009
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 35080169 | OH | Primary |
Addresses
Primary practice location
311 S 15TH St
Coshocton, OH 43812-1873
Mailing address
PO Box 57
West Lafayette, OH 43845-0057
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2006742 | Medicaid | OH |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1200009600000",
"number": "1306886627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 57",
"city": "WEST LAFAYETTE",
"state": "OH",
"postal_code": "438450057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 S 15TH ST",
"city": "COSHOCTON",
"state": "OH",
"postal_code": "438121873",
"telephone_number": "740-622-0799",
"fax_number": "740-622-0636"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDICAL SERICES OF COSHOCTON, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-07",
"last_updated": "2008-01-11",
"status": "A",
"authorized_official_last_name": "MILLER",
"authorized_official_first_name": "ROBERT",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "740-623-4009"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": "OH",
"license": "35080169",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2006742",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Coshocton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.