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General NPI Number Information
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NPI Number | 1942566690
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Entity Type | Individual
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Provider Name | JAYESH C VALLABH MD, MBA
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Gender | Male
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Dates
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Enumeration Date | 04/06/2012
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Last Update Date | 10/26/2018
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Provider Practice Location Address
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Address Line | 480 MEDICAL CENTER DR 1018 DODD HALL
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City | COLUMBUS
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State | OH
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Zip | 43210
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Country | US
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Telephone | 614-293-4295
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Fax | 614-293-3809
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Provider Business Mailing Address
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Address Line | 480 MEDICAL CENTER DR 1011 DODD HALL
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City | COLUMBUS
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State | OH
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Zip | 43210-1229
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Country | US
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Telephone | 614-293-4295
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Fax | 614-293-3809
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 35.129402
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 35129402
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License Number State | OH
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