Healthcare Provider Details

I. General information

NPI: 1386898609
Provider Name (Legal Business Name): DONALDSON PLASTIC SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2008
Last Update Date: 11/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 METRO PL S 400A
DUBLIN OH
43017-5351
US

IV. Provider business mailing address

565 METRO PL S 400A
DUBLIN OH
43017-5351
US

V. Phone/Fax

Practice location:
  • Phone: 614-760-1694
  • Fax:
Mailing address:
  • Phone: 614-760-1694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number091300
License Number StateOH

VIII. Authorized Official

Name: DR. JEFFREY HUGH DONALDSON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 614-760-7694