Healthcare Provider Details

I. General information

NPI: 1649356304
Provider Name (Legal Business Name): MADELYN RENEE SARTAIN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RENEE SARTAIN DO

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 12/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6810 PERIMETER DR STE 100
DUBLIN OH
43016
US

IV. Provider business mailing address

PO BOX 3731
DUBLIN OH
43016-0374
US

V. Phone/Fax

Practice location:
  • Phone: 614-766-2220
  • Fax: 614-799-3023
Mailing address:
  • Phone: 614-766-2220
  • Fax: 614-799-3023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number34003964
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number34003964
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number34003964
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number34003964
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number34003964
License Number StateOH
# 6
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34003964
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: