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General NPI Number Information
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NPI Number | 1861449407
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Entity Type | Organization
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Legal Business Name | OSU OTOLARYNGOLOGY HEAD AND NECK SURGERY, LLC
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 04/28/2017
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Provider Practice Location Address
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Address Line | 915 OLENTANGY RIVER RD SUITE 4000
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City | COLUMBUS
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State | OH
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Zip | 43212-3153
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Country | US
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Telephone | 614-366-3687
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Fax | 614-293-3193
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Provider Business Mailing Address
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Address Line | 915 OLENTANGY RIVER RD SUITE 4000
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City | COLUMBUS
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State | OH
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Zip | 43212-3153
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MARK INMAN
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Credential |
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Telephone | 614-293-3470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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