Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 35070502 | OH |
NPI | 1013033455 |
---|---|
Provider Name | Ellin F. Gafford |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43210-1257 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 13/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2021627 | (05) | OH |
G41069 | (02) | OH |