Healthcare Provider Details

I. General information

NPI: 1750330551
Provider Name (Legal Business Name): UNIVERSITY OTOLARYNGOLOGISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6670 PERIMETER DR STE 120
DUBLIN OH
43016-8064
US

IV. Provider business mailing address

1810 MACKENZIE DR 2ND FLOOR
COLUMBUS OH
43220-2967
US

V. Phone/Fax

Practice location:
  • Phone: 614-273-2230
  • Fax: 614-273-2255
Mailing address:
  • Phone: 614-273-2250
  • Fax: 614-273-2255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207WX0109X
TaxonomyNeuro-ophthalmology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: MS. HOLLY BEZOLD
Title or Position: CEO
Credential:
Phone: 614-233-2356