Healthcare Provider Details

I. General information

NPI: 1609366863
Provider Name (Legal Business Name): COLUMBUS RADIOLOGY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2018
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S GRANT AVE
COLUMBUS OH
43215-4701
US

IV. Provider business mailing address

PO BOX 202260
DALLAS TX
75320-2260
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-9000
  • Fax:
Mailing address:
  • Phone: 614-566-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN MARIE VAUGHN
Title or Position: AO
Credential:
Phone: 629-317-1465