Provider Demographics
NPI:1891758561
Name:FARABAUGH, RONALD JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:JOHN
Last Name:FARABAUGH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2879 E DUBLIN GRANVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-4063
Mailing Address - Country:US
Mailing Address - Phone:614-898-0787
Mailing Address - Fax:
Practice Address - Street 1:2879 E DUBLIN GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-4063
Practice Address - Country:US
Practice Address - Phone:614-898-0787
Practice Address - Fax:614-898-1945
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH939111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0496922Medicaid
OH0496922Medicaid
OHFA0518245Medicare PIN