Provider Demographics
NPI:1134482151
Name:ROSEANN MORRISON
Entity Type:Organization
Organization Name:ROSEANN MORRISON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:614-870-0000
Mailing Address - Street 1:5212 W. BROAD ST.
Mailing Address - Street 2:SUITE F
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-1642
Mailing Address - Country:US
Mailing Address - Phone:614-870-0000
Mailing Address - Fax:614-870-2225
Practice Address - Street 1:5212 W BROAD ST
Practice Address - Street 2:STE F
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1642
Practice Address - Country:US
Practice Address - Phone:614-556-4616
Practice Address - Fax:888-334-2606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH360028804213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0946061Medicaid
OH0745912Medicare PIN