BUCKEYE ORAL & MAXILLOFACIAL SURGEY; NPI #1073855193

Contact Information

BUCKEYE ORAL & MAXILLOFACIAL SURGEY

110 POLARIS PARKWAY
SUITE 110
WESTERVILLE, OH 43082-0000

Phone: 614-794-9700
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oral and Maxillofacial Surgery	261QS0112X

Indicates primary specialty

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NPI Profile & details for BUCKEYE ORAL & MAXILLOFACIAL SURGEY

NPI # 1073855193

LBN Legal business name BUCKEYE ORAL & MAXILLOFACIAL SURGEY

Authorized official JACK MCEWAN - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/27/2013

Last updated 03/27/2013 - About 13 years ago

Identifiers

OH	License #	30022456
OH	Medicaid	2711882

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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