Individual
DR. MICHAEL JAY SOMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
751 FOREST AVE, SUITE 400, ZANESVILLE, OH 43701-2868
(740) 452-4053
(740) 452-4580
Mailing address
751 FOREST AVE, SUITE 400, ZANESVILLE, OH 43701-2868
(740) 452-4053
(740) 452-4580
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
35046011S
OH
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
35046011
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000122287
ANTHEM PROVIDER NUMBER
OH
05
—
0469738
—
OH
01
—
311597742
TAX ID
OH
Enumeration date
08/19/2005
Last updated
08/13/2008
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