Healthcare Provider Details

I. General information

NPI: 1669512877
Provider Name (Legal Business Name): CASIA ELIZABETH HORSEMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 UPHAM DR
COLUMBUS OH
43210-1250
US

IV. Provider business mailing address

1670 UPHAM DR
COLUMBUS OH
43210-1250
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-9600
  • Fax:
Mailing address:
  • Phone: 614-293-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR1275
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number35121228
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: