Basic Information
| Provider Information | |||||||||
| NPI: | 1023364486 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5776 PARKSIDE XING | ||||||||
| Address2: | APT/SUITE | ||||||||
| City: | DUBLIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430169374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2165348688 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1670 UPHAM DR | ||||||||
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| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432101250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142939600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2012 | ||||||||
| LastUpdateDate: | 08/02/2012 | ||||||||
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| AuthorizedOfficialLastName: | RHOADES | ||||||||
| AuthorizedOfficialFirstName: | JANET | ||||||||
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| AuthorizedOfficialTitleorPosition: | RESIDENCY COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 6142934540 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | Y | Hospitals | Psychiatric Hospital |
No ID Information.