Organization
COLUMBUS SUBOXONE DOCTORS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS LAURIA (ADMINISTRATOR)
(614) 655-8956
Entity
Organization
Contact information
Practice address
3225 SULLIVANT AVE, COLUMBUS, OH 43204-1837
(614) 655-8956
(614) 748-0569
Mailing address
3225 SULLIVANT AVE, COLUMBUS, OH 43204-1837
(614) 655-8956
(614) 748-0569
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
03/11/2019
Last updated
01/13/2021
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