Healthcare Provider Details

I. General information

NPI: 1821203209
Provider Name (Legal Business Name): SCOTT F LEIBOWITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 05/05/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

IV. Provider business mailing address

1670 UPHAM DR
COLUMBUS OH
43210-1250
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-5445
  • Fax: 614-722-4575
Mailing address:
  • Phone: 614-293-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number35.129502
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: