Individual
JEANNIE PO CO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5775 N MEADOWS DR STE D, GROVE CITY, OH 43123-7300
(614) 224-4200
(614) 224-4207
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-6200
(606) 408-5338
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
43916
KY
207RN0300X
Nephrology Physician
Primary
35.099404
OH
207RN0300X
Nephrology Physician
43916
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000726032
ANTHEM BCBS
KY
05
—
3148178
—
OH
05
—
3810020217
—
WV
05
—
7100164770
—
KY
01
—
932670
AETNA
—
01
—
P01045712
RAILROAD MEDICARE
KY
Enumeration date
04/17/2007
Last updated
04/29/2022
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