Individual
PHYLLIS VISOCAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1669 W LANE AVE, COLUMBUS, OH 43221-3339
(614) 487-1212
(614) 487-1141
Mailing address
1669 W LANE AVE, COLUMBUS, OH 43221-3339
(614) 487-1212
(614) 487-1141
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35036423
OH
207W00000X
Ophthalmology Physician
4301034155
MI
207W00000X
Ophthalmology Physician
G29024
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34330690
LABCORP
OH
Enumeration date
11/15/2006
Last updated
07/09/2007
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