Healthcare Provider Details

I. General information

NPI: 1639297138
Provider Name (Legal Business Name): URBAN PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3433 AGLER RD SUITE 1300
COLUMBUS OH
43219-3387
US

IV. Provider business mailing address

3433 AGLER RD SUITE 1300
COLUMBUS OH
43219-3388
US

V. Phone/Fax

Practice location:
  • Phone: 614-476-1901
  • Fax: 614-476-8748
Mailing address:
  • Phone: 614-476-1901
  • Fax: 614-476-8748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LAWRENCE B WATKINS
Title or Position: PARTNER
Credential: M.D.
Phone: 614-746-1901