Unknown Individual – Orthopaedic Surgery Physician, NPI 1073517710

Unknown Individual is a healthcare provider. based in Marysville, Ohio. specializing in Orthopaedic Surgery Physician. They hold a License No. 35-063404 (OH). The NPI Number for Unknown Individual is 1073517710

Main info

Organization
Inactive
42 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1073517710
Phone
(724) 548-7009
Address
120 COLEMANS XING
Deactivation Date
26 April 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9375782275
Graduation Year
1984 (42 years ago)
PAC ID
1153233739
Group Practice PAC ID
1557419173
Professional Enrollment ID
I20081024000189
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 120, Colemans Crossing Boulevard, Millcreek Meadows, Marysville, Union County, Ohio, 43040, United States

    MARYSVILLE, OH 430407115

    Phone: (724) 548-7009

    Fax: (724) 543-6557

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 43040)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1557419173View full group profile
NameSpecialtyState
-OH
G A S T R O E N T E R O L O G YOH
-OH
P S Y C H I A T R YOH
Family PracticeOH
Physician AssistantOH
Clinical Social WorkerOH
Sports MedicineOH
N E U R O L O G YOH
General SurgeryOH

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1073517710 for Unknown Individual.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Marysville, Ohio?
For routing, start with Marysville, Ohio for Unknown Individual, then verify phone and hours locally.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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