Healthcare Provider Details

I. General information

NPI: 1871733121
Provider Name (Legal Business Name): ELISE MICHELE BARRETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELISE YASMEEN SADOUN

II. Dates (important events)

Enumeration Date: 02/26/2009
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2365 INNIS RD
COLUMBUS OH
43224-3730
US

IV. Provider business mailing address

5000 E MAIN ST
COLUMBUS OH
43213-2440
US

V. Phone/Fax

Practice location:
  • Phone: 614-235-5555
  • Fax: 614-536-1994
Mailing address:
  • Phone: 614-235-5555
  • Fax: 614-536-1994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License NumberP2163
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberP2163
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: