MEDICARE: FLOORTJE JENNISKENS BACKES MD

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	207VX0201X	Gynecologic Oncology Physician	35.094277	OH
2	207V00000X	Obstetrics & Gynecology Physician	35.094277	OH

General Provider Information

NPI Number	:	1124231998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FLOORTJE JENNISKENS BACKES MD

Provider Business Mailing Address
First Line	:	700 ACKERMAN RD STE 2120
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43202-1559
Country	:	US
Telephone Number	:	614-293-3873
Fax Number	:	614-293-3078

Provider Business Practice Location Address
First Line	:	3651 RIDGE MILL DR
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026
Country	:	US
Telephone Number	:	614-293-3873
Fax Number	:	614-293-3078

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	04/06/2026

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