1033303599 NPI number — COSMETIC & PLASTIC SURGERY OF COLUMBUS, INC.

Table of content: DR. BRIAN LEE SELLERS OD (NPI 1255426276)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033303599 NPI number — COSMETIC & PLASTIC SURGERY OF COLUMBUS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COSMETIC & PLASTIC SURGERY OF COLUMBUS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033303599
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
41 COMMERCE PARK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTERVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43082-8348
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-890-5565
Provider Business Mailing Address Fax Number:
614-890-5561

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41 COMMERCE PARK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTERVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43082-8348
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-890-5565
Provider Business Practice Location Address Fax Number:
614-890-5561
Provider Enumeration Date:
08/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HOUSER
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
SCOTT
Authorized Official Title or Position:
SURGEON/OWNER
Authorized Official Telephone Number:
614-890-5565

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  34006992 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com