Healthcare Provider Details

I. General information

NPI: 1427007087
Provider Name (Legal Business Name): ARTEMIS LASER AND VEIN CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 01/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6108 PARKCENTER CIR
DUBLIN OH
43017-3583
US

IV. Provider business mailing address

6108 PARKCENTER CIR
DUBLIN OH
43017-3583
US

V. Phone/Fax

Practice location:
  • Phone: 614-793-8346
  • Fax: 614-793-8349
Mailing address:
  • Phone: 614-793-8346
  • Fax: 614-793-8349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ERNEST DEBOURBON
Title or Position: PRESIDENT
Credential: MD
Phone: 614-793-8346