Individual
JEREMY R. MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1313 OLENTANGY RIVER RD, COLUMBUS, OH 43212-3120
(614) 839-3275
(614) 547-8881
Mailing address
70 S CLEVELAND AVE, WESTERVILLE, OH 43081-1397
(614) 839-3275
(614) 823-8881
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
34.008175
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11519723
CAQH
OH
05
—
2552116
—
OH
Enumeration date
11/29/2005
Last updated
03/12/2016
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