Basic Information
| Provider Information | |||||||||
| NPI: | 1538309448 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COLUMBUS ORTHOPAEDIC GROUP, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | THE CARDINAL ORTHOPAEDIC INSTITUTE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 170 TAYLOR STATION RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432134441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145457900 | ||||||||
| FaxNumber: | 6145457901 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 POLARIS PKWY | ||||||||
| Address2: | SUITE 2150 | ||||||||
| City: | WESTERVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430827989 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6147591186 | ||||||||
| FaxNumber: | 6147590043 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2009 | ||||||||
| LastUpdateDate: | 01/11/2012 | ||||||||
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| AuthorizedOfficialLastName: | INGRAM | ||||||||
| AuthorizedOfficialFirstName: | DALE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6145457900 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | OH | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.