MEDICARE: MR. JAMES KINGSBURY II MD

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	2085R0204X	Vascular & Interventional Radiology Physician	25IA12814900	NJ
2	2085R0204X	Vascular & Interventional Radiology Physician	35.136836	OH
3	2085R0202X	Diagnostic Radiology Physician	25IA12814900	NJ

General Provider Information

NPI Number	:	1780002238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES KINGSBURY II MD

Provider Business Mailing Address
First Line	:	700 ACKERMAN RD STE 2120
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43202-1559
Country	:	US
Telephone Number	:	614-293-8315
Fax Number	:

Provider Business Practice Location Address
First Line	:	395 W 12TH AVE FL 4
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43210-1267
Country	:	US
Telephone Number	:	614-293-8315
Fax Number	:	614-293-6935

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2014
Last Update Date	:	03/24/2026

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