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General NPI Number Information
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NPI Number | 1922464437
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Entity Type | Organization
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Legal Business Name | TOWN STREET MEDICAL, LLC
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Dates
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Enumeration Date | 01/13/2016
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | TOWN STREET MEDICAL LLC DBA COLUMBUS IMMEDIATE CARE 3781 S HIGH STREET
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City | COLUMBUS
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State | OH
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Zip | 43207-4011
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Country | US
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Telephone | 614-221-3300
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Fax | 614-221-7858
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Provider Business Mailing Address
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Address Line | 1809 DRURY LN
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City | NICHOLS HILLS
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State | OK
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Zip | 73116-5311
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Country | US
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Telephone | 614-284-8073
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MRS. MONA L ROYDER
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Credential | M.S. M.T.
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Telephone | 405-601-3330
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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 | OH34-003964
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License Number State | OH
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