Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Apr 21, 2009
License(s)
35122211 (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 420 N JAMES RD | Columbus, OH 43219-1834 | 614-257-5200 |
| LOCATION | 6879 WENTWORTH DR | New Albany, OH 43054-9440 | 614-257-5200 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.