Healthcare Provider Details

I. General information

NPI: 1306605597
Provider Name (Legal Business Name): CALEB HAEUSSLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

697 THOMAS LN
COLUMBUS OH
43214-3931
US

IV. Provider business mailing address

697 THOMAS LN
COLUMBUS OH
43214-3931
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-5414
  • Fax: 614-533-0433
Mailing address:
  • Phone: 614-566-5414
  • Fax: 614-533-0433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.154230
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number35.154230
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: