Basic Information
| Provider Information | |||||||||
| NPI: | 1568442119 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ENGLEHART | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | II | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | L-3800 | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432603800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6147611255 | ||||||||
| FaxNumber: | 6145520168 | ||||||||
| Practice Location | |||||||||
| Address1: | 262 NEIL AVE STE 500 | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432157313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148276600 | ||||||||
| FaxNumber: | 6148276690 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 35-069681 | OH | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 2091687 | 05 | OH | MEDICAID |