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General NPI Number Information
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NPI Number | 1093762635
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Entity Type | Organization
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Legal Business Name | NEW ALBANY ORTHOPEDIC ANESTHESIA LLC
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 3600 STELZER RD STE 100
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City | COLUMBUS
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State | OH
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Zip | 43219-3676
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Country | US
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Telephone | 614-285-7844
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Fax | 614-516-0821
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Provider Business Mailing Address
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Address Line | PO BOX 4877
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City | NEWARK
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State | OH
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Zip | 43058
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Country | US
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Telephone | 614-285-7844
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Fax | 614-516-0821
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | MARK RENO
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Credential | D.O.
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Telephone | 614-285-7844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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