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Individual

JOHN C GARRIOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
671 EDGEWOOD DR SE, BROOKFIELD, OH 44403-9720
(330) 448-6351
Mailing address
671 EDGEWOOD DR SE, BROOKFIELD, OH 44403-9720
(330) 448-6351
(330) 448-4439

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01034735A
IN
2085R0202X
Diagnostic Radiology Physician
Primary
35035426
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000225723
UNISON
OH
01
000000527824
ANTHEM
OH
01
0304914
BCMH
OH
05
0891174
OH
01
421783
WELLCARE
OH
01
751140
BUCKEYE
OH
01
7541366
AETNA
OH
01
P00412459
RAILROAD MEDICARE
OH
Enumeration date
10/05/2006
Last updated
05/22/2008
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