Healthcare Provider Details

I. General information

NPI: 1679313027
Provider Name (Legal Business Name): HAILEY MARIE OZARZAK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2024
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W CHERRY ST
SUNBURY OH
43074-3575
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-685-2805
  • Fax: 614-366-3562
Mailing address:
  • Phone: 614-685-2805
  • Fax: 614-366-3562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.008633RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: