Healthcare Provider Details

I. General information

NPI: 1750620712
Provider Name (Legal Business Name): MR. ISAAC KWAME BINEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2013
Last Update Date: 07/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4733 TAMARACK BLVD
COLUMBUS OH
43229-6577
US

IV. Provider business mailing address

2975 BENNINGTON AVE
COLUMBUS OH
43231-6001
US

V. Phone/Fax

Practice location:
  • Phone: 614-312-4277
  • Fax:
Mailing address:
  • Phone: 614-943-1870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: