Provider Demographics
NPI:1750455085
Name:IMAGYN MEDICAL ASSOCIATES, LTD
Entity Type:Organization
Organization Name:IMAGYN MEDICAL ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:FOSS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:614-851-6551
Mailing Address - Street 1:5131 BEACON HILL RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-4442
Mailing Address - Country:US
Mailing Address - Phone:614-851-6551
Mailing Address - Fax:614-851-5855
Practice Address - Street 1:5131 BEACON HILL RD
Practice Address - Street 2:SUITE 320
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-4442
Practice Address - Country:US
Practice Address - Phone:614-851-6551
Practice Address - Fax:614-851-5855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2203912Medicaid
OH2203912Medicaid