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Organization
WESTERVILLE PHYSICIAN INC.
Active
Organization
WESTERVILLE PHYSICIAN INC.
Active
Other names
Capital Park Famly Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA WILLIS (FINANCE SUPERVISOR)
(614) 546-4232
Entity
Organization
Contact information
Practice address
2150 AGLER RD, COLUMBUS, OH 43224-4523
(614) 416-4325
(614) 416-4320
Mailing address
2150 AGLER RD, COLUMBUS, OH 43224-4523
(614) 416-4325
(614) 416-4320
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0113230
UNITED HEALTH CARE
OH
05
—
2493289
—
OH
05
—
2550645
—
OH
Enumeration date
06/25/2006
Last updated
08/22/2020
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