Individual
LARRY J LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 THOMAS LN STE 3A, COLUMBUS, OH 43214-1419
(614) 566-4510
Mailing address
5450 FRANTZ RD STE 360, DUBLIN, OH 43016-4141
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35039979
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0431670
—
OH
Enumeration date
06/21/2006
Last updated
01/05/2022
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