Healthcare Provider Details
I. General information
NPI: 1437699386
Provider Name (Legal Business Name): JONATHAN GRANT SEFTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/26/2017
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5131 BEACON HILL RD STE 310C
COLUMBUS OH
43228-4442
US
IV. Provider business mailing address
PO BOX 7527
DUBLIN OH
43017-0727
US
V. Phone/Fax
- Phone: 614-788-3700
- Fax: 614-878-7005
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 34.015121 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: