Southern Ohio Pathology Consultants Inc

Organization Active NPI Anatomic Pathology & Clinical Pathology Physician · Cincinnati, OH

NPI 1831173202 · NPPES record last updated Dec 13, 2007

Key facts

NPI
1831173202
Entity type
Organization (NPI type 2)
Primary specialty
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
Legal business name
SOUTHERN OHIO PATHOLOGY CONSULTANTS INC
Practice address
375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone
(513) 872-1400
NPI assigned
Nov 30, 2005
Organization subpart
No

Authorized official

Name
Dr. Thomas W. Panke, M.D.
Title
President
Phone
(513) 872-1400

Practitioners 93

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 93

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040602000357 OH Part B Supplier - Clinic/Group Practice 3971585217 Receives reassigned benefits from 19 practitioners
Practice locations: Fairfield, OH; Cincinnati, OH; Batavia, OH

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207ZP0102X Yes

Addresses

Primary practice location

375 Dixmyth Ave
Cincinnati, OH 45220-2475

Mailing address

PO Box 632242
Cincinnati, OH 45263-2242
Phone (800) 503-6254

Other identifiers

IdentifierTypeStateIssuer
CA1041OtherOHRAILROAD MEDICARE
000000016917OtherOHBCBS
65923773MedicaidKY
2076784MedicaidOH

Other providers in Cincinnati, OH

All providers in Cincinnati, OH · Anatomic Pathology & Clinical Pathology Physician in Ohio

Sources for this page

Verify at the official NPI Registry.