Provider Demographics
NPI:1881087112
Name:OSU HEALTH SYSTEM NEUROSURGERY
Entity type:Organization
Organization Name:OSU HEALTH SYSTEM NEUROSURGERY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-293-2229
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-685-4601
Mailing Address - Fax:614-366-3731
Practice Address - Street 1:460 W 10TH AVE FL 5
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-8074
Practice Address - Fax:614-293-3193
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OSU HEALTH SYSTEM NEUROSURGERY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-11
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0121379Medicaid