Provider Demographics
NPI:1730351602
Name:COLUMBUS OPHTHALMOLOGY CENTER I, LTD
Entity type:Organization
Organization Name:COLUMBUS OPHTHALMOLOGY CENTER I, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-939-1600
Mailing Address - Street 1:6357 N HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1590
Mailing Address - Country:US
Mailing Address - Phone:614-939-1600
Mailing Address - Fax:614-939-0585
Practice Address - Street 1:6357 N HAMILTON RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-1590
Practice Address - Country:US
Practice Address - Phone:614-939-1600
Practice Address - Fax:614-939-0585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35051085174400000X
OH35.051085174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHDC5244OtherRAILROAD MEDICARE
OH9345901Medicare PIN