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General NPI Number Information
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NPI Number | 1538749106
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Entity Type | Individual
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Provider Name | JAMES DEAN LERAKIS MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 3555 OLENTANGY RIVER RD STE 1080
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City | COLUMBUS
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State | OH
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Zip | 43214-3984
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Country | US
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Telephone | 614-268-8164
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Fax | 614-268-8406
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Provider Business Mailing Address
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Address Line | 3555 OLENTANGY RIVER RD STE 1080
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City | COLUMBUS
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State | OH
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Zip | 43214-3984
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Country | US
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Telephone | 614-268-8164
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Fax | 614-268-8406
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.151140
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License Number State | OH
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