Healthcare Provider Details

I. General information

NPI: 1063995017
Provider Name (Legal Business Name): HYPERBARIC THERAPY OF DUBLIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2018
Last Update Date: 09/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6750 AVERY MUIRFIELD DR
DUBLIN OH
43017-1202
US

IV. Provider business mailing address

4977 DUNKERRIN CT
DUBLIN OH
43017-8900
US

V. Phone/Fax

Practice location:
  • Phone: 614-407-4268
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: CHRIS DODSON
Title or Position: CLINIC COORDINATOR/OWNER
Credential:
Phone: 614-407-4268