MEDICARE: HEALTHSERVE MEDICAL GROUP LLC

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	261QU0200X	Urgent Care Clinic/Center
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1386988004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHSERVE MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	2939 KENNY RD STE 200
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-2406
Country	:	US
Telephone Number	:	614-442-2431
Fax Number	:	614-442-2426

Provider Business Practice Location Address
First Line	:	445 ROCKY FORK BLVD
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-3336
Country	:	US
Telephone Number	:	614-442-2431
Fax Number	:	614-442-2426

Authorized Official
Title or Position	:	SECRETARY/TREASURER
Name	:	MICHAEL C BOURLAND
Credential	:
Telephone Number	:	614-442-2431

Provider Enumeration Date	:	11/19/2012
Last Update Date	:	10/02/2013

Similar Medicare Providers

1780676395 — MIFFLIN TOWNSHIP TRUSTEES
Practice Location Address:

475 ROCKY FORK BLVD
GAHANNA, OH
43230-3336

Practice Phone: 614-471-0542
Practice Fax:

1790732188 — TODD DAVID TROY PA-C
Practice Location Address:

445 ROCKY FORK BLVD
GAHANNA, OH
43230-3336

Practice Phone: 614-383-7660
Practice Fax: 614-383-7665

1134536584 — HEALTHSERVE PRIMARY CARE, LLC
Practice Location Address:

445 ROCKY FORK BLVD
GAHANNA, OH
43230-3336

Practice Phone: 614-442-2431
Practice Fax: 614-442-2426

1962806570 — HEALTHSERVE MEDICAL GROUP LLC
Practice Location Address:

445 ROCKY FORK BLVD STE A
GAHANNA, OH
43230-3336

Practice Phone: 614-442-2431
Practice Fax: 614-442-2426

1447658026 — LINDSEY R. TANN APRN-CNP
Practice Location Address:

445 ROCKY FORK BLVD
GAHANNA, OH
43230-3336

Practice Phone: 614-383-7660
Practice Fax: 614-383-7665

1023400157 — WHITNEY C. KHAIRA PA-C
Practice Location Address:

445 ROCKY FORK BLVD
GAHANNA, OH
43230-3336

Practice Phone: 614-383-7660
Practice Fax: 614-383-7665

Directions to “HEALTHSERVE MEDICAL GROUP LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.