Provider Demographics
NPI:1730238312
Name:SURGICAL NEUROLOGY OF NORTH CENTRAL OHIO, INC
Entity type:Organization
Organization Name:SURGICAL NEUROLOGY OF NORTH CENTRAL OHIO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:TIMPERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-522-1100
Mailing Address - Street 1:295 GLESSNER AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-2270
Mailing Address - Country:US
Mailing Address - Phone:419-522-1100
Mailing Address - Fax:419-522-4118
Practice Address - Street 1:295 GLESSNER AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-2270
Practice Address - Country:US
Practice Address - Phone:419-522-1100
Practice Address - Fax:419-522-4118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35027380T174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty