Healthcare Provider Details

I. General information

NPI: 1649225707
Provider Name (Legal Business Name): GREGORY D. PEARSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 S 18TH ST FIRST FLOOR
COLUMBUS OH
43205-2654
US

IV. Provider business mailing address

700 CHILDREN'S DRIVE ED. BLDG. 3RD FLOOR
COLUMBUS OH
43205-2664
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-3887
  • Fax: 614-722-5826
Mailing address:
  • Phone: 614-722-4823
  • Fax: 614-722-3903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number35.077074
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number35077074
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: