Basic Information
| Provider Information | |||||||||
| NPI: | 1578556817 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FEIBEL | ||||||||
| FirstName: | JONATHAN | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | M.D. | ||||||||
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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: | 170 TAYLOR STATION RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432134441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145457900 | ||||||||
| FaxNumber: | 6145457901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2005 | ||||||||
| LastUpdateDate: | 03/23/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 35071113 | OH | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0004X | 35071113 | OH | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Foot and Ankle Surgery |
ID Information
| ID | Type | State | Issuer | Description | 2205385 | 05 | OH | MEDICAID | 2514292 | 01 | OH | BCMH | OTHER | 000000349497 | 01 | OH | ANTHEM | OTHER | 7653142 | 01 | OH | AETNA | OTHER |