Healthcare Provider Details

I. General information

NPI: 1326627506
Provider Name (Legal Business Name): HEATHER BURTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
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: 614-355-6000
  • Fax:
Mailing address:
  • Phone: 614-355-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080S0010X
TaxonomyPediatric Sports Medicine Physician
License Number35.152731
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: