Provider Demographics
NPI:1255790408
Name:ORTHOPAEDIC AND SPINE CENTER
Entity type:Organization
Organization Name:ORTHOPAEDIC AND SPINE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KEDAR
Authorized Official - Middle Name:
Authorized Official - Last Name:DESHPANDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-468-0300
Mailing Address - Street 1:1080 POLARIS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-6035
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1080 POLARIS PKWY STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-6035
Practice Address - Country:US
Practice Address - Phone:614-469-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004563RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty