Provider Demographics
NPI:1073741195
Name:GOSLIN, BRENT J (MD)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:J
Last Name:GOSLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3545 OLENTANGY RIVER RD STE 525
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3983
Mailing Address - Country:US
Mailing Address - Phone:614-261-1900
Mailing Address - Fax:614-261-7538
Practice Address - Street 1:3545 OLENTANGY RIVER RD STE 525
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3983
Practice Address - Country:US
Practice Address - Phone:614-261-1900
Practice Address - Fax:614-261-7538
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34014676208600000X, 2086S0102X
MI4301094772208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care