1245272566 NPI number — ANESTHESIA ASSOCIATES OF SOUTHERN OHIO, INC.

Table of content: (NPI 1245272566)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245272566 NPI number — ANESTHESIA ASSOCIATES OF SOUTHERN OHIO, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANESTHESIA ASSOCIATES OF SOUTHERN OHIO, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245272566
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3626 RUFFIN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92123-1810
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1805 27TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45662-2640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-356-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PRINCIPE
Authorized Official First Name:
NEIL
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
123-456-7890

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 65936908 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000204159 . This is a "BC/BS - ANTHEM HEALTH SYS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2245387 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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