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Individual

JOHN TYCHONIEVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2222 WELCOME PL, COLUMBUS, OH 43209-7813
(614) 533-6800
(614) 338-8735
Mailing address
5350 FRANTZ RD, DUBLIN, OH 43016-4259

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
121624
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0088630
OH
Enumeration date
06/22/2009
Last updated
11/14/2013
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