Healthcare Provider Details

I. General information

NPI: 1265010185
Provider Name (Legal Business Name): CAMERON LEE MCMAHEN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 N HAMILTON RD STE 600
GAHANNA OH
43230-1757
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-2663
  • Fax: 614-293-2053
Mailing address:
  • Phone: 614-293-2663
  • Fax: 614-293-2053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberDP225598
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36.004256
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: