Provider Demographics
NPI:1114344538
Name:ROSBOROUGH, KELLY
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:ROSBOROUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 TAYLOR STATION RD STE 300
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-4440
Mailing Address - Country:US
Mailing Address - Phone:614-434-2400
Mailing Address - Fax:614-324-0622
Practice Address - Street 1:150 TAYLOR STATION RD STE 300
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-4440
Practice Address - Country:US
Practice Address - Phone:614-434-2400
Practice Address - Fax:614-324-0622
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34012663207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology