Healthcare Provider Details

I. General information

NPI: 1801920913
Provider Name (Legal Business Name): EMERALD PEDIATRICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 01/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5695 INNOVATION DRIVE SUITE 100
DUBLIN OH
43016
US

IV. Provider business mailing address

5695 INNOVATION DRIVE SUITE 100
DUBLIN OH
43016
US

V. Phone/Fax

Practice location:
  • Phone: 614-932-5050
  • Fax: 614-932-9372
Mailing address:
  • Phone: 614-932-5050
  • Fax: 614-932-9372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRISTIN E THOMPSON
Title or Position: PRESIDENT
Credential: MD
Phone: 614-932-5050