MEDICARE: COLUMBUS CARDIOVASCULAR AND THORACIC SURGERY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	35038137T	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114021797
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLUMBUS CARDIOVASCULAR AND THORACIC SURGERY INC

Provider Business Mailing Address
First Line	:	200 BRADENTON AVE
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43017-7515
Country	:	US
Telephone Number	:	614-793-1982
Fax Number	:

Provider Business Practice Location Address
First Line	:	1750 CHURCHVIEW LN
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-4902
Country	:	US
Telephone Number	:	614-271-2166
Fax Number	:	614-451-0178

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN W. THOMAS
Credential	:	M.D.
Telephone Number	:	614-271-2166

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	04/24/2017

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