Provider Demographics
NPI:1851476543
Name:DOCTORS HOUSE CALL OF COLUMBUS
Entity Type:Organization
Organization Name:DOCTORS HOUSE CALL OF COLUMBUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-581-0981
Mailing Address - Street 1:PO BOX 2374
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43216
Mailing Address - Country:US
Mailing Address - Phone:614-221-6870
Mailing Address - Fax:614-221-6890
Practice Address - Street 1:849 HARMON AVENUE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223
Practice Address - Country:US
Practice Address - Phone:614-221-6870
Practice Address - Fax:614-221-6890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0211443Medicaid
G26961Medicare UPIN
OH0211443Medicaid