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Organization

CENTRAL OHIO MEDICAL MANAGEMENT LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GINA MARIE NICHOLS MD (CEO)
(614) 577-1948
Entity
Organization

Contact information

Practice address
1755 LANCASTER AVE, REYNOLDSBURG, OH 43068-3108
(614) 577-1948
(614) 577-1948
Mailing address
PO BOX 513, PICKERINGTON, OH 43147-0513
(614) 577-1948

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.086704
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2611267
OH
Enumeration date
02/08/2018
Last updated
04/20/2018
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