NPIMap

Organization Active NPI

Kolodzik Physician Services, LLC

  • General Practice Physician
  • Bellbrook, OH
National Provider Identifier
1902264351
Registry record updated Jan 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
35052684 Issued in OH
Legal business name
KOLODZIK PHYSICIAN SERVICES, LLC
Practice address
1108 Paxon CT
Bellbrook, OH 45305-8959
Phone
(937) 825-6220
NPI assigned
Jan 31, 2016
Last updated
Jan 31, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Paul W. Kolodzik, M.D.
Title
Owner
Phone
(937) 825-6220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 35052684 OH Primary

Addresses

Primary practice location

1108 Paxon CT
Bellbrook, OH 45305-8959

Mailing address

1108 Paxon CT
Bellbrook, OH 45305-8959
Phone (937) 825-6220

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454198400000",
    "number": "1902264351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 PAXON CT",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453058959",
            "telephone_number": "937-825-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 PAXON CT",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453058959",
            "telephone_number": "937-825-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOLODZIK PHYSICIAN SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-31",
        "last_updated": "2016-01-31",
        "status": "A",
        "authorized_official_last_name": "KOLODZIK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-825-6220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35052684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellbrook, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.