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NPI Code Detail

MEDICARE: MR. JON CLIFFORD HENRY MD

MEDICARE: MR. JON CLIFFORD HENRY 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
12086S0129XVascular Surgery Physician35.094730OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689833360
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JON CLIFFORD HENRY MD
Provider Business Mailing Address
First Line : 5400 FRANTZ RD STE 250
Second Line :
City : DUBLIN
State : OH
Zip : 43016-6102
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 285 E STATE ST STE 260
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-4322
Country : US
Telephone Number : 614-566-9035
Fax Number : 614-566-9302
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2008
Last Update Date : 01/25/2022

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