Healthcare Provider Details

I. General information

NPI: 1023013133
Provider Name (Legal Business Name): THE MILLHON CLINIC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7630 RIVERS EDGE DR
COLUMBUS OH
43235-1337
US

IV. Provider business mailing address

7630 RIVERS EDGE DR
COLUMBUS OH
43235-1337
US

V. Phone/Fax

Practice location:
  • Phone: 614-540-3944
  • Fax: 614-540-3979
Mailing address:
  • Phone: 614-540-3944
  • Fax: 614-540-3979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: MRS. MARGARET B CONNOR
Title or Position: PRACTICE MANAGER
Credential:
Phone: 614-540-3944