Healthcare Provider Details

I. General information

NPI: 1053705020
Provider Name (Legal Business Name): JARED MATTHEW STROUD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 E TOWN ST STE 116
COLUMBUS OH
43215-4799
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-9000
  • Fax:
Mailing address:
  • Phone: 614-293-5123
  • Fax: 614-293-4890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.131692
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number35.131692
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: