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NPI Code Detail

MEDICARE: COLUMBUS OPHTHALMOLOGY ASSOCIATES LLC

MEDICARE: COLUMBUS OPHTHALMOLOGY ASSOCIATES 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
1207W00000XOphthalmology Physician

General Provider Information

NPI Number : 1790171866
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLUMBUS OPHTHALMOLOGY ASSOCIATES LLC
Provider Business Mailing Address
First Line : 5155 BRADENTON AVE
Second Line : SECOND FLOOR
City : DUBLIN
State : OH
Zip : 43017-7558
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3959 HOOVER RD
Second Line :
City : GROVE CITY
State : OH
Zip : 43123-2839
Country : US
Telephone Number : 614-766-2006
Fax Number : 614-766-4637
Authorized Official
Title or Position : MANAGER
Name : DANIELLE CRANS
Credential :
Telephone Number : 614-526-6209
Provider Enumeration Date : 04/15/2015
Last Update Date : 04/15/2015

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