| Mylaurel Medical Group Oh, Llc | |
|
1201 Dublin Rd Columbus OH 43215-1045 | |
| (886) 619-7803 | |
| Not Available |
| Full Name | Mylaurel Medical Group Oh, Llc |
|---|---|
| Speciality | General Practice |
| Location | 1201 Dublin Rd, Columbus, Ohio |
| Authorized Official Name and Position | Branko Kolvek (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 3474972452 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mylaurel Medical Group Oh, Llc 885 3rd Ave Fl 29 New York NY 10022-4834 Ph: (866) 619-7803 | Mylaurel Medical Group Oh, Llc 1201 Dublin Rd Columbus OH 43215-1045 Ph: (886) 619-7803 |
| NPI Number | 1104643634 |
|---|---|
| Provider Enumeration Date | 09/25/2024 |
| Last Update Date | 09/25/2024 |
| Medicare PECOS PAC ID | 9436689114 |
|---|---|
| Medicare Enrollment ID | O20250211000830 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104643634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Jamie Babcock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508121708 PECOS PAC ID: 1557515574 Enrollment ID: I20130129000060 |
| Provider Name | Clay Watson |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1104072636 PECOS PAC ID: 7416088430 Enrollment ID: I20250217000906 |
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