Individual
JOHN FULTON HEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3705 OLENTANGY RIVER RD, STE 260, COLUMBUS, OH 43214-3467
(614) 533-6600
(614) 533-6609
Mailing address
5450 FRANTZ RD, 250, DUBLIN, OH 43016-4134
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1088
SC
207Q00000X
Family Medicine Physician
200600893
NC
207Q00000X
Family Medicine Physician
Primary
34008458
OH
207QS0010X
Sports Medicine (Family Medicine) Physician
1088
SC
207QS0010X
Sports Medicine (Family Medicine) Physician
200600893
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
34008458
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010883
—
SC
01
—
1088
MEDICAL LICENSE
SC
05
—
5916171
—
NC
01
—
P00436180
RAILROAD MEDICARE PTAN
SC
05
—
PENDING
—
OH
Enumeration date
06/08/2007
Last updated
01/25/2022
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