Healthcare Provider Details

I. General information

NPI: 1427133750
Provider Name (Legal Business Name): COLE-SEDIVY & CASEY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260 HENDERSON RD SUITE 100
COLUMBUS OH
43220-4388
US

IV. Provider business mailing address

3260 HENDERSON RD SUITE 100
COLUMBUS OH
43220-4388
US

V. Phone/Fax

Practice location:
  • Phone: 614-545-2002
  • Fax: 614-545-7546
Mailing address:
  • Phone: 614-545-2002
  • Fax: 614-545-7546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34-004212
License Number StateOH

VIII. Authorized Official

Name: DEBORAH L COLE-SEDIVY
Title or Position: OWNER/PRESIDENT
Credential: DO
Phone: 614-545-2002