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NPI Code Detail

MEDICARE: DR. HERBERT RAY ESTIS JR. M.D.

MEDICARE: DR. HERBERT RAY ESTIS JR. M.D.
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
1207Q00000XFamily Medicine Physician35041298OH

General Provider Information

NPI Number : 1326145988
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HERBERT RAY ESTIS JR. M.D.
Provider Business Mailing Address
First Line : 7920 BENNINGTON AVE
Second Line :
City : CANAL WINCHESTER
State : OH
Zip : 43110-9262
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2200 W BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43223-1297
Country : US
Telephone Number : 614-752-0333
Fax Number : 614-752-0385
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2006
Last Update Date : 07/08/2007

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