Basic Information
| Provider Information | |||||||||
| NPI: | 1467605261 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OSU INTERNAL MEDICINE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 473 W 12TH AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432101252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142477737 | ||||||||
| FaxNumber: | 6142935614 | ||||||||
| Practice Location | |||||||||
| Address1: | 473 W 12TH AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432101252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142477737 | ||||||||
| FaxNumber: | 6142935614 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2008 | ||||||||
| LastUpdateDate: | 12/13/2010 | ||||||||
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| AuthorizedOfficialLastName: | TALBOTT | ||||||||
| AuthorizedOfficialFirstName: | DARLA | ||||||||
| AuthorizedOfficialMiddleName: | MARIE | ||||||||
| AuthorizedOfficialTitleorPosition: | NURSE PRACTITIONER | ||||||||
| AuthorizedOfficialTelephone: | 6142477737 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | CNP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | 1447359997 | OH | Y | Hospitals | General Acute Care Hospital | Critical Access |
No ID Information.