Provider Demographics
NPI:1396911418
Name:DIONISIO, REBECCA LYNN (DO)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:DIONISIO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:614-788-6010
Mailing Address - Fax:614-533-6226
Practice Address - Street 1:800 MCCONNELL DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3463
Practice Address - Country:US
Practice Address - Phone:614-533-6297
Practice Address - Fax:614-533-6226
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.010384207P00000X, 207PH0002X
IL036129774207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program