Stacy L Scudder, | |
6201 Gender Rd, Canal Winchester, OH 43110-2007 | |
(614) 834-8042 | |
(614) 837-8035 |
Full Name | Stacy L Scudder |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 6201 Gender Rd, Canal Winchester, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598707515 | NPI | - | NPPES |
2191748 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 34.007025 (Ohio) | Primary |
Entity Name | Central Ohio Primary Care Physicians, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194705194 PECOS PAC ID: 2769383785 Enrollment ID: O20040114000204 |
Mailing Address | Practice Location Address |
---|---|
Stacy L Scudder, 6201 Gender Rd, Canal Winchester, OH 43110-2007 Ph: (614) 834-8042 | Stacy L Scudder, 6201 Gender Rd, Canal Winchester, OH 43110-2007 Ph: (614) 834-8042 |
Nicholas Steve Stevens, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 7750 Diley Rd Ste A, Canal Winchester, OH 43110 Phone: 614-837-7337 Fax: 614-837-7335 | |
Julie R Javorek, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 6201 Gender Rd, Canal Winchester, OH 43110 Phone: 614-834-8042 Fax: 614-837-8035 | |
Laura V Bowser, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 6201 Gender Rd, Canal Winchester, OH 43110 Phone: 614-834-8042 Fax: 614-837-8035 | |
Tyler Fick, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 7901 Diley Rd Ste 150, Canal Winchester, OH 43110 Phone: 614-355-9050 | |
Rachael Esther Levine, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 7901 Diley Rd Ste 150, Canal Winchester, OH 43110 Phone: 614-355-9050 | |
Sara L Welsh, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 6201 Gender Rd, Canal Winchester, OH 43110 Phone: 614-834-8042 Fax: 614-837-8035 |