Individual
LISA HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205
(614) 722-4200
(614) 722-4203
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-4200
(614) 722-4203
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35-095153
OH
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
35095153
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3039161
—
OH
01
—
H185751
CGS - MEDICARE
OH
Enumeration date
05/01/2007
Last updated
03/11/2026
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