Provider Demographics
NPI:1598281719
Name:WHITEHALL ANIMAL HOSPITAL, NMRK, LLC
Entity Type:Organization
Organization Name:WHITEHALL ANIMAL HOSPITAL, NMRK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, HEAD VETERINARIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUFFUS
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:614-235-9164
Mailing Address - Street 1:4199 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-3029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4199 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-3029
Practice Address - Country:US
Practice Address - Phone:614-235-9164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-18
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6692261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center