Healthcare Provider Details

I. General information

NPI: 1336102888
Provider Name (Legal Business Name): THOMAS PATRICK ARCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 COOPER RD STE 200
WESTERVILLE OH
43081-8054
US

IV. Provider business mailing address

1322 BERKELEY CT
POWELL OH
43065-7809
US

V. Phone/Fax

Practice location:
  • Phone: 614-627-2000
  • Fax: 614-221-8869
Mailing address:
  • Phone: 614-847-1898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35065935A
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number35065935A
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207RA0002X
TaxonomyAdult Congenital Heart Disease Physician
License Number35065935A
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: