Provider Demographics
NPI:1588626808
Name:ALTHOF, JAMES E (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:ALTHOF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1350 W 5TH AVE
Mailing Address - Street 2:SUITE 228
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2962
Mailing Address - Country:US
Mailing Address - Phone:614-334-6451
Mailing Address - Fax:614-334-6452
Practice Address - Street 1:1350 W 5TH AVE
Practice Address - Street 2:SUITE 228
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2962
Practice Address - Country:US
Practice Address - Phone:614-334-6451
Practice Address - Fax:614-334-6452
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH3117103TC0700X
NC0877103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCP05515Medicare UPIN
OHCP05511Medicare UPIN