Organization
THORACIC AND CARDIOVASCULAR SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS J TISHKO MD (PRESIDENT)
(614) 575-8500
Entity
Organization
Contact information
Practice address
6275 E BROAD ST, COLUMBUS, OH 43213-1504
(614) 575-8500
(614) 575-8500
Mailing address
PO BOX 650, BLACKLICK, OH 43004-0650
(614) 575-8500
(614) 575-8500
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
35054319T
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0922238
—
OH
Enumeration date
08/07/2007
Last updated
12/03/2010
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