Individual
LANCE MILES MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
303 E TOWN ST, COLUMBUS, OH 43215-4601
(614) 788-5000
(614) 788-5100
Mailing address
303 E TOWN ST, COLUMBUS, OH 43215-4601
(614) 788-5000
(614) 788-5100
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
34.009863
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074923
—
OH
01
—
H250561
MCR OPG PTAN
—
Enumeration date
07/12/2007
Last updated
01/25/2022
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