Individual
JACK LAURENCE BIRKENBEUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MBA
Contact information
Practice address
915 OLENTANGY RIVER RD STE 4000, COLUMBUS, OH 43212-3154
(614) 293-9215
(614) 293-1923
Mailing address
2266 SISKIN AVE, COLUMBUS, OH 43228-9007
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
57.252400
OH
Other
Enumeration date
06/23/2022
Last updated
06/23/2022
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