MEDICARE: DR. LEON MARGOLIN 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	208VP0000X	Pain Medicine Physician	35.090064	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
2	9391481	OTHER		PTAN

General Provider Information

NPI Number	:	1619178308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEON MARGOLIN MD

Provider Business Mailing Address
First Line	:	5245 E MAIN ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-2503
Country	:	US
Telephone Number	:	718-530-5953
Fax Number	:	614-453-8222

Provider Business Practice Location Address
First Line	:	5245 E MAIN ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-2503
Country	:	US
Telephone Number	:	718-530-5953
Fax Number	:	614-453-8222

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

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	02/18/2015

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