Healthcare Provider Details

I. General information

NPI: 1326285024
Provider Name (Legal Business Name): DUBLIN PEDIATRICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2009
Last Update Date: 01/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5110 BLAZER PKWY
DUBLIN OH
43017-1339
US

IV. Provider business mailing address

5110 BLAZER PKWY
DUBLIN OH
43017-1339
US

V. Phone/Fax

Practice location:
  • Phone: 614-889-8890
  • Fax: 614-799-6878
Mailing address:
  • Phone: 614-889-8890
  • Fax: 614-799-6878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35050543
License Number StateOH

VIII. Authorized Official

Name: MS. JANNA R. LOAR
Title or Position: BUSINESS OFFICER
Credential:
Phone: 614-889-8890