Healthcare Provider Details

I. General information

NPI: 1568456804
Provider Name (Legal Business Name): WILLIAM B SALT II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 03/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E MAIN ST 140
COLUMBUS OH
43215-5369
US

IV. Provider business mailing address

630 MOHAWK ST
COLUMBUS OH
43206-1153
US

V. Phone/Fax

Practice location:
  • Phone: 614-427-3161
  • Fax:
Mailing address:
  • Phone: 614-746-4520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35035077
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: