Basic Information
| Provider Information | |||||||||
| NPI: | 1639519838 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WEXNER MEDICAL CENTER AT OHIO STATE UNIVERSITY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 376 WEST 10TH AVENUE | ||||||||
| Address2: | 776 PRIOR HALL | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142933551 | ||||||||
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| Practice Location | |||||||||
| Address1: | 376 WEST 10TH AVENUE | ||||||||
| Address2: | 776 PRIOR HALL | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142933551 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2013 | ||||||||
| LastUpdateDate: | 07/02/2013 | ||||||||
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| AuthorizedOfficialLastName: | HARR-WEATHERBY | ||||||||
| AuthorizedOfficialFirstName: | ELLEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | RESIDENCY PROGRAM COORDINATO | ||||||||
| AuthorizedOfficialTelephone: | 6142933551 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.