Healthcare Provider Details

I. General information

NPI: 1932150869
Provider Name (Legal Business Name): DAVID C ELAND DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 09/23/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 PARKS HALL
ATHENS OH
45701
US

IV. Provider business mailing address

5450 FRANTZ RD STE 360
DUBLIN OH
43016-4141
US

V. Phone/Fax

Practice location:
  • Phone: 740-593-2447
  • Fax: 740-593-2422
Mailing address:
  • Phone: 614-544-6155
  • Fax: 614-544-6370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number02000871A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number34 006125 E
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: