Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 35.093622 | OH |
NPI | 1083829246 |
---|---|
Provider Name | Garth Fedric Essig JR. |
First Address | Columbus, OH 43212-3153 |
Second Address | Columbus, OH 43212-3153 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 31/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2957493 | (05) | OH |