Organization
CENTRAL OHIO NEUROLOGY INC
Active
Organization
CENTRAL OHIO NEUROLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND J BADDOUR MD (OWNER)
(419) 756-6990
Entity
Organization
Contact information
Practice address
370 CLINE AVENUE, STE C5, MANSFIELD, OH 44907-1057
(419) 756-6990
(419) 756-0944
Mailing address
370 CLINE AVE, STE C5, MANSFIELD, OH 44907-1057
(419) 756-6990
(419) 756-0944
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000182209
ANTHEM
OH
05
—
2877801
—
OH
01
—
30022664
RAILROAD MEDICARE
OH
01
—
606176800
DEPT OF LABOR ID
OH
Enumeration date
02/14/2007
Last updated
08/27/2012
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