Healthcare Provider Details

I. General information

NPI: 1710944814
Provider Name (Legal Business Name): OHIO STATE UNIVERSITY ORTHOPEDIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

543 TAYLOR AVE
COLUMBUS OH
43203-1278
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-2663
  • Fax: 614-293-2053
Mailing address:
  • Phone: 614-293-2663
  • Fax: 614-293-2053

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: JAMI HENSLEY
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 614-293-2229