MEDICARE: OSU UROLOGY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician

General Provider Information

NPI Number	:	1588612568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSU UROLOGY, LLC

Provider Business Mailing Address
First Line	:	700 ACKERMAN RD STE 2120
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43202-1559
Country	:	US
Telephone Number	:	614-293-8155
Fax Number	:	614-293-3565

Provider Business Practice Location Address
First Line	:	915 OLENTANGY RIVER RD
Second Line	:	SUITE 2000
City	:	COLUMBUS
State	:	OH
Zip	:	43212-3153
Country	:	US
Telephone Number	:	614-293-8155
Fax Number	:	614-293-3565

Authorized Official
Title or Position	:	ADMINISTRATIVE DIRECTOR
Name	:	JAMI HENSLEY
Credential	:
Telephone Number	:	614-293-2229

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	02/05/2025

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Directions to “OSU UROLOGY, LLC ” Practice Location

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