=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144255340
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID HOANG M.D
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/12/2006
-----------------------------------------------------
Last Update Date | 02/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 460 W CENTRAL AVE
-----------------------------------------------------
City | DELAWARE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43015-1405
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-369-8751
-----------------------------------------------------
Fax | 740-363-7265
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 340 POLARIS PKWY
-----------------------------------------------------
City | WESTERVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43082-7971
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-545-7900
-----------------------------------------------------
Fax | 614-545-7901
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207XX0005X
-----------------------------------------------------
Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
-----------------------------------------------------
License Number | 35078858
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------