Healthcare Provider Details

I. General information

NPI: 1023711033
Provider Name (Legal Business Name): LINDSAY FANNIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 BUTTERFLY GARDENS DR
COLUMBUS OH
43215-4985
US

IV. Provider business mailing address

405 BUTTERFLY GARDENS DR
COLUMBUS OH
43215-4985
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-5525
  • Fax:
Mailing address:
  • Phone: 614-722-5525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number35.155982
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: