Provider Demographics
NPI:1013070374
Name:DOCTORS HOUSE CALL OF COLUMBUS, LLC.
Entity type:Organization
Organization Name:DOCTORS HOUSE CALL OF COLUMBUS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BOYD
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-221-6870
Mailing Address - Street 1:595 E BROAD ST FL 3
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-3985
Mailing Address - Country:US
Mailing Address - Phone:614-221-6870
Mailing Address - Fax:614-221-6890
Practice Address - Street 1:595 E BROAD ST FL 3
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-3985
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:2006-12-18
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35067569R261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2710856Medicaid
OH9366571Medicare PIN
OHG26961Medicare UPIN