Healthcare Provider Details

I. General information

NPI: 1538879069
Provider Name (Legal Business Name): ADVANTAGE ORTHOPEDICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2022
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6670 PERIMETER DR STE 140
DUBLIN OH
43016-8057
US

IV. Provider business mailing address

6670 PERIMETER DR STE 140
DUBLIN OH
43016-8057
US

V. Phone/Fax

Practice location:
  • Phone: 614-526-2153
  • Fax: 614-526-2151
Mailing address:
  • Phone: 614-526-2150
  • Fax: 614-526-2151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: THOMAS JOSEPH KOVACK
Title or Position: PRESIDENT/CEO/ PHYSICIAN
Credential: DO
Phone: 614-526-2153