Healthcare Provider Details

I. General information

NPI: 1801932447
Provider Name (Legal Business Name): JOAQUIN CASTANEDA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 12/22/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 E STATE ST SUITE 500
COLUMBUS OH
43215-4354
US

IV. Provider business mailing address

5350 FRANTZ RD
DUBLIN OH
43016-4259
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-7777
  • Fax: 614-566-8880
Mailing address:
  • Phone: 614-544-6355
  • Fax: 614-544-6350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number230703
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35088370
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: