1083063341 NPI number — ORTHOPEDIC ONE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083063341 NPI number — ORTHOPEDIC ONE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPEDIC ONE, 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:
1083063341
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
170 TAYLOR STATION RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43213-4491
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-545-7900
Provider Business Mailing Address Fax Number:
614-545-7901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3600 STELZER RD
Provider Second Line Business Practice Location Address:
SUITE 240
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43219-3040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-827-1300
Provider Business Practice Location Address Fax Number:
614-827-0877
Provider Enumeration Date:
06/08/2016

Additional Information

Authorized Official

Authorized Official Last Name:
POLITI
Authorized Official First Name:
JOEL
Authorized Official Middle Name:
Authorized Official Title or Position:
MD/ AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
614-545-7900

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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