Organization
IMPACT PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAWN HACKSHAW MD (OWNER)
(614) 459-6510
Entity
Organization
Contact information
Practice address
1910 BETHEL RD, COLUMBUS, OH 43220-1864
(614) 824-2546
(614) 824-2549
Mailing address
1910 BETHEL RD, COLUMBUS, OH 43220-1864
(614) 824-2546
(614) 824-2549
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0051229
—
OH
Enumeration date
08/05/2011
Last updated
06/15/2012
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