Individual
MRS. JODY LEE WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005258RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0296562
—
OH
Enumeration date
07/25/2014
Last updated
05/14/2026
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