Provider Demographics
NPI:1154512622
Name:JEFFREY S SAMS MD
Entity Type:Organization
Organization Name:JEFFREY S SAMS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-235-2326
Mailing Address - Street 1:150 TAYLOR STATION RD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-4441
Mailing Address - Country:US
Mailing Address - Phone:614-235-2326
Mailing Address - Fax:614-235-5194
Practice Address - Street 1:150 TAYLOR STATION RD
Practice Address - Street 2:SUITE 290
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-4441
Practice Address - Country:US
Practice Address - Phone:614-235-2326
Practice Address - Fax:614-235-5194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2237565Medicaid
OH9315411Medicare PIN