Provider Demographics
NPI:1083829246
Name:ESSIG, GARTH FEDRIC JR (MD)
Entity type:Individual
Prefix:
First Name:GARTH
Middle Name:FEDRIC
Last Name:ESSIG
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE 4000
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3153
Mailing Address - Country:US
Mailing Address - Phone:614-293-3470
Mailing Address - Fax:614-293-7292
Practice Address - Street 1:915 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3153
Practice Address - Country:US
Practice Address - Phone:614-366-3687
Practice Address - Fax:614-293-6176
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.093622207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2957493Medicaid
OH2957493Medicaid