MEDICARE: DR. JONATHAN LEE HAIMES 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
1	207VG0400X	Gynecology Physician	35066575	OH
2	2083A0300X	Addiction Medicine (Preventive Medicine) Physician	36.066575	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	:	1437145935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN LEE HAIMES M.D.

Provider Business Mailing Address
First Line	:	5925 CLEVELAND AVE
Second Line	:	SUITE B
City	:	COLUMBUS
State	:	OH
Zip	:	43231
Country	:	US
Telephone Number	:	614-776-4646
Fax Number	:	614-398-0039

Provider Business Practice Location Address
First Line	:	5925 CLEVELAND AVE
Second Line	:	SUITE B
City	:	COLUMBUS
State	:	OH
Zip	:	43231
Country	:	US
Telephone Number	:	614-776-4646
Fax Number	:	614-398-0039

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

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	06/24/2021

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