Healthcare Provider Details

I. General information

NPI: 1003983743
Provider Name (Legal Business Name): ROBERT TODD GORSLINE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3777 TRUEMAN CT
HILLIARD OH
43026-2496
US

IV. Provider business mailing address

340 POLARIS PKWY
WESTERVILLE OH
43082-7971
US

V. Phone/Fax

Practice location:
  • Phone: 614-488-1816
  • Fax:
Mailing address:
  • Phone: 614-545-7900
  • Fax: 614-545-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35082522
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number35082522
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: