MEDICARE: COLUMBUS NEUROLOGICAL GROUP 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	174400000X	Specialist

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	:	1265527857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLUMBUS NEUROLOGICAL GROUP INC

Provider Business Mailing Address
First Line	:	5340 E MAIN ST
Second Line	:	SUITE 100
City	:	COLUMBUS
State	:	OH
Zip	:	43213-2574
Country	:	US
Telephone Number	:	614-866-5555
Fax Number	:	614-866-1051

Provider Business Practice Location Address
First Line	:	5340 E MAIN ST
Second Line	:	SUITE 100
City	:	COLUMBUS
State	:	OH
Zip	:	43213-2574
Country	:	US
Telephone Number	:	614-866-5555
Fax Number	:	614-866-1051

Authorized Official
Title or Position	:	MD
Name	:	DR. DAVID F LANG
Credential	:
Telephone Number	:	614-866-5555

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	09/10/2007

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Directions to “COLUMBUS NEUROLOGICAL GROUP INC ” Practice Location

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