Healthcare Provider Details

I. General information

NPI: 1144210006
Provider Name (Legal Business Name): JOSEPH J RUANE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 01/05/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3773 OLENTANGY RIVER RD
COLUMBUS OH
43214-3425
US

IV. Provider business mailing address

5350 FRANTZ RD
DUBLIN OH
43016-4259
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-3810
  • Fax: 614-566-3895
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number34005532
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: