Healthcare Provider Details

I. General information

NPI: 1114186137
Provider Name (Legal Business Name): JESSE W MINDEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 KENNY RD
COLUMBUS OH
43221
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-4969
  • Fax: 614-293-6111
Mailing address:
  • Phone: 614-293-4969
  • Fax: 614-293-6111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number35.122249
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number35122249
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number35122249
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: