Provider Demographics
NPI:1609250232
Name:ORTHOPAEDIC & SPINE CENTER LLC
Entity Type:Organization
Organization Name:ORTHOPAEDIC & SPINE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR / MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEDAR
Authorized Official - Middle Name:KRISHNA
Authorized Official - Last Name:DESHPANDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-468-0284
Mailing Address - Street 1:1080 POLARIS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-6035
Mailing Address - Country:US
Mailing Address - Phone:614-468-0284
Mailing Address - Fax:614-468-0210
Practice Address - Street 1:1080 POLARIS PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-6035
Practice Address - Country:US
Practice Address - Phone:614-468-0284
Practice Address - Fax:614-468-0210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH021271225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty