Basic Information
Provider Information
NPI: 1437699386
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SEFTON
FirstName: JONATHAN
MiddleName: GRANT
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7527
Address2:  
City: DUBLIN
State: OH
PostalCode: 430170727
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 5193 W BROAD ST STE 200
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432281695
CountryCode: US
TelephoneNumber: 6147883700
FaxNumber: 6148787005
Other Information
ProviderEnumerationDate: 02/26/2017
LastUpdateDate: 12/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X34.015121OHY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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