Healthcare Provider Details

I. General information

NPI: 1821626946
Provider Name (Legal Business Name): KELLY HYNES DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2090 FRANK RD
COLUMBUS OH
43223-3735
US

IV. Provider business mailing address

2090 FRANK RD
COLUMBUS OH
43223-3735
US

V. Phone/Fax

Practice location:
  • Phone: 614-525-5290
  • Fax:
Mailing address:
  • Phone: 614-525-5290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number34.017887
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: