Healthcare Provider Details

I. General information

NPI: 1396674859
Provider Name (Legal Business Name): ALEX RENSHAW ORTHOPEDICS AND LONGEVITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2156 ELGIN RD
COLUMBUS OH
43221-4137
US

IV. Provider business mailing address

2156 ELGIN RD
COLUMBUS OH
43221-4137
US

V. Phone/Fax

Practice location:
  • Phone: 402-650-5279
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEX RENSHAW
Title or Position: OWNER
Credential:
Phone: 866-974-2673