Individual
SHELLY GUPTA JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
915 OLENTANGY RIVER RD, COLUMBUS, OH 43212-3153
(614) 293-8116
(614) 293-4719
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(614) 293-8116
(614) 293-3555
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
35097638
OH
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
35097638
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0054348
—
OH
Enumeration date
06/07/2007
Last updated
02/05/2021
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