Provider Demographics
NPI:1831431162
Name:DAVID HEALY DO PULMONARY MEDICINE LLC
Entity type:Organization
Organization Name:DAVID HEALY DO PULMONARY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:MAGEE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:740-657-1122
Mailing Address - Street 1:PO BOX 677
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-0677
Mailing Address - Country:US
Mailing Address - Phone:740-657-1122
Mailing Address - Fax:
Practice Address - Street 1:3693 DARBY KNOLLS BLVD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7293
Practice Address - Country:US
Practice Address - Phone:740-657-1122
Practice Address - Fax:740-657-1148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-25
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007249207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2557335Medicaid