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General NPI Number Information
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NPI Number | 1992200414
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Entity Type | Individual
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Provider Name | JACQUELINE MORIN MD
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Gender | Female
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 700 CHILDRENS DR
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City | COLUMBUS
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State | OH
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Zip | 43205-2639
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Country | US
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Telephone | 614-722-6636
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Fax |
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Provider Business Mailing Address
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Address Line | 115 E 5TH AVE APT 513
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City | COLUMBUS
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State | OH
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Zip | 43201-4088
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Country | US
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Telephone | 276-620-0682
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Fax |
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 35.147650
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License Number State | OH
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