Healthcare Provider Details

I. General information

NPI: 1174918858
Provider Name (Legal Business Name): RYAN M BARSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2015
Last Update Date: 06/02/2021
Certification Date: 06/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 N CLEVELAND AVE STE 200
WESTERVILLE OH
43082-8642
US

IV. Provider business mailing address

465 N CLEVELAND AVE STE 200
WESTERVILLE OH
43082-8642
US

V. Phone/Fax

Practice location:
  • Phone: 614-899-0000
  • Fax: 614-899-0524
Mailing address:
  • Phone: 614-899-0000
  • Fax: 614-899-0524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35132052
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number35132052
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: