Organization
SOUTHERN OHIO PATHOLOGY CONSULTANTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS W. PANKE M.D. (PRESIDENT)
(513) 872-1400
Entity
Organization
Contact information
Practice address
375 DIXMYTH AVE, CINCINNATI, OH 45220-2475
(513) 872-1400
Mailing address
PO BOX 632242, CINCINNATI, OH 45263-2242
(800) 503-6254
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000016917
BCBS
OH
05
—
2076784
—
OH
05
—
65923773
—
KY
01
—
CA1041
RAILROAD MEDICARE
OH
Enumeration date
11/30/2005
Last updated
12/13/2007
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