Healthcare Provider Details

I. General information

NPI: 1073079257
Provider Name (Legal Business Name): JAMES TURNER WOLFE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2019
Last Update Date: 02/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

453 W 10TH AVE
COLUMBUS OH
43210-2205
US

IV. Provider business mailing address

557 IVERSON WAY
GALLOWAY OH
43119-8347
US

V. Phone/Fax

Practice location:
  • Phone: 614-366-8058
  • Fax:
Mailing address:
  • Phone: 606-465-2234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN178327
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: