Provider Demographics
NPI:1568442119
Name:ENGLEHART, THOMAS W II (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:ENGLEHART
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:L-3800
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43260-3800
Mailing Address - Country:US
Mailing Address - Phone:614-761-1255
Mailing Address - Fax:614-552-0168
Practice Address - Street 1:262 NEIL AVE STE 500
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-7313
Practice Address - Country:US
Practice Address - Phone:614-827-6600
Practice Address - Fax:614-827-6690
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-069681207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2091687Medicaid
OH2091687Medicaid
OHEN0852824Medicare ID - Type Unspecified