Healthcare Provider Details
I. General information
NPI: 1164477915
Provider Name (Legal Business Name): BRENT HALE ADLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/23/2006
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
700 CHILDRENS DR
COLUMBUS OH
43205-2664
US
IV. Provider business mailing address
700 CHILDRENS DR
COLUMBUS OH
43205-2664
US
V. Phone/Fax
- Phone: 614-722-6200
- Fax:
- Phone: 614-722-4579
- Fax: 614-722-4565
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 35072630 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085P0229X |
| Taxonomy | Pediatric Radiology Physician |
| License Number | 35072630 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: