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NPI Code Detail

MEDICARE: DOUGLAS LUNSFORD

MEDICARE: DOUGLAS LUNSFORD
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
1171M00000XCase Manager/Care Coordinator
2101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.169549OH

General Provider Information

NPI Number : 1669954103
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS LUNSFORD
Provider Business Mailing Address
First Line : 5925 CLEVELAND AVE STE B
Second Line :
City : COLUMBUS
State : OH
Zip : 43231-2209
Country : US
Telephone Number : 614-776-4646
Fax Number : 614-398-0039
Provider Business Practice Location Address
First Line : 5925 CLEVELAND AVE STE B
Second Line :
City : COLUMBUS
State : OH
Zip : 43231-2209
Country : US
Telephone Number : 614-776-4646
Fax Number : 614-398-0039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2018
Last Update Date : 01/30/2019

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Directions to “ DOUGLAS LUNSFORD ” Practice Location

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