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NPI Code Detail

MEDICARE: OHIO STATE UNIVERSITY

MEDICARE: OHIO STATE UNIVERSITY
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
12084A0401XAddiction Medicine (Psychiatry & Neurology) Physician

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 : 1801854724
Entity Type Code : Organization
Provider Name (Legal Business Name) : OHIO STATE UNIVERSITY
Provider Business Mailing Address
First Line : 700 ACKERMAN RD
Second Line : SUITE 570
City : COLUMBUS
State : OH
Zip : 43202-1559
Country : US
Telephone Number : 614-293-2391
Fax Number : 614-293-4359
Provider Business Practice Location Address
First Line : 181 TAYLOR AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43203-1779
Country : US
Telephone Number : 614-257-3760
Fax Number : 614-257-3148
Authorized Official
Title or Position : DIRECTOR CORPORATE CREDENTIALING
Name : ANNE SMITH
Credential :
Telephone Number : 614-293-7444
Provider Enumeration Date : 05/02/2006
Last Update Date : 02/02/2017

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Directions to “OHIO STATE UNIVERSITY ” Practice Location

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