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General NPI Number Information
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NPI Number | 1801262118
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Entity Type | Organization
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Legal Business Name | JLH CLINICAL SERVICES
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Dates
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Enumeration Date | 08/20/2015
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Last Update Date | 01/07/2016
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Provider Practice Location Address
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Address Line | 5925 CLEVELAND AVE
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City | COLUMBUS
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State | OH
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Zip | 43231-2208
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Country | US
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Telephone | 740-601-6071
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Fax |
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Provider Business Mailing Address
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Address Line | 5925 CLEVELAND AVE
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City | COLUMBUS
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State | OH
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Zip | 43231-2208
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Country | US
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Telephone | 740-601-6071
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JONATHAN HAIMES
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Credential |
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Telephone | 740-601-6071
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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 | 35066575
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License Number State | CO
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