Healthcare Provider Details

I. General information

NPI: 1760492516
Provider Name (Legal Business Name): ORTHOPAEDIC AND TRAUMA SURGEONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 06/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4605 SAWMILL RD
UPPER ARLINGTON OH
43220-2246
US

IV. Provider business mailing address

4605 SAWMILL RD
UPPER ARLINGTON OH
43220-2246
US

V. Phone/Fax

Practice location:
  • Phone: 614-827-8700
  • Fax: 614-827-8701
Mailing address:
  • Phone: 614-827-8700
  • Fax: 614-827-8701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateOH

VIII. Authorized Official

Name: DR. JOHN S WOLFE
Title or Position: PRESIDENT OF THE BOARD
Credential: MD
Phone: 614-827-8700