Provider Demographics
NPI:1376294900
Name:COLUMBUS EYELID PLASTIC SURGERY, LLC
Entity Type:Organization
Organization Name:COLUMBUS EYELID PLASTIC SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-397-2404
Mailing Address - Street 1:4113 CLAIRMONT RD
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43220-4501
Mailing Address - Country:US
Mailing Address - Phone:614-397-2404
Mailing Address - Fax:
Practice Address - Street 1:725 BUCKLES CT N STE 110
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-6884
Practice Address - Country:US
Practice Address - Phone:614-397-2404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic SurgeryGroup - Single Specialty