Provider Demographics
NPI:1053465336
Name:DUBLIN MEDICAL CLINIC INC II
Entity Type:Organization
Organization Name:DUBLIN MEDICAL CLINIC INC II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:D
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:614-764-5600
Mailing Address - Street 1:6880 PERIMETER DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-2520
Mailing Address - Country:US
Mailing Address - Phone:614-764-5600
Mailing Address - Fax:614-764-5605
Practice Address - Street 1:6880 PERIMETER DR
Practice Address - Street 2:SUITE B
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-2520
Practice Address - Country:US
Practice Address - Phone:614-764-5600
Practice Address - Fax:614-764-5605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHDU9918531Medicare ID - Type Unspecified