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General NPI Number Information
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NPI Number | 1609250273
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Entity Type | Individual
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Provider Name | KENNETH IWUAFOR PA-C, CAQ-PSYCH
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Gender | Male
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Dates
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Enumeration Date | 07/14/2015
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 2700 E DUBLIN GRANVILLE RD STE 300KK
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City | COLUMBUS
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State | OH
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Zip | 43231-4094
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Country | US
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Telephone | 614-284-3446
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Fax | 614-633-1534
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Provider Business Mailing Address
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Address Line | 2700 E DUBLIN GRANVILLE RD STE 300KK
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City | COLUMBUS
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State | OH
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Zip | 43231-4094
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Country | US
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Telephone | 614-284-3446
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Fax | 614-633-1534
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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 | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 50.004316RX
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number | 50.004316RX
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.004316RX
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License Number State | OH
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