| Central Ohio Geriatrics Llc | |
|
590 Newark Granville Rd Granville OH 43023-1436 | |
| (888) 531-7444 | |
| (888) 531-7444 |
| Full Name | Central Ohio Geriatrics Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 590 Newark Granville Rd, Granville, Ohio |
| Authorized Official Name and Position | John Mark Weigand (PRESIDENT) |
| Authorized Official Contact | 8885317444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Ohio Geriatrics Llc Po Box 378 Granville OH 43023-0378 Ph: (888) 531-7444 | Central Ohio Geriatrics Llc 590 Newark Granville Rd Granville OH 43023-1436 Ph: (888) 531-7444 |
| NPI Number | 1073753794 |
|---|---|
| Provider Enumeration Date | 02/21/2009 |
| Last Update Date | 07/30/2019 |
| Medicare PECOS PAC ID | 7517015373 |
|---|---|
| Medicare Enrollment ID | O20090505000139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073753794 | NPI | - | NPPES |
| 2968267 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 35-060271 (Ohio) | Primary |
| Provider Name | Jonathan Hollister |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1487621652 PECOS PAC ID: 4880627256 Enrollment ID: I20050915000778 |
| Provider Name | John M Weigand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780624965 PECOS PAC ID: 9234149758 Enrollment ID: I20060428000061 |
| Provider Name | Stuart Kanter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730122193 PECOS PAC ID: 1052324449 Enrollment ID: I20060802000127 |
| Provider Name | Katherine L Montanaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083763627 PECOS PAC ID: 2466453725 Enrollment ID: I20070130000002 |
| Provider Name | Peter D Hucek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548274871 PECOS PAC ID: 2961559372 Enrollment ID: I20090421000629 |
| Provider Name | Stephanie A.f. Dolan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154655314 PECOS PAC ID: 1557498995 Enrollment ID: I20100416000329 |
| Provider Name | Caryn Elizabeth Gorby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144626433 PECOS PAC ID: 7719201102 Enrollment ID: I20150112002252 |
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