Organization
LIVINGSTON LOCKBOURNE AVE FAMILY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEVON D RATLIFF MSA (GENERAL MANAGER)
(614) 252-0917
Entity
Organization
Contact information
Practice address
1289 E LIVINGSTON AVE, COLUMBUS, OH 43205-2838
(614) 252-0917
(614) 252-6153
Mailing address
1289 E LIVINGSTON AVE, COLUMBUS, OH 43205-2838
(614) 252-0917
(614) 252-6153
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0559417
—
OH
01
—
71454
AETNA HMO ID
OH
01
—
CM09933
RAILROAD
OH
Enumeration date
06/29/2006
Last updated
02/04/2010
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