DR. PHILLIP T LATHAM (NPI# 1437215308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437215308 |
| Entity Type | Individual |
| Full Name | DR. PHILLIP T LATHAM |
| Credential | D.D.S. |
| Practice Address |
4488 W Broad St Columbus OH 43228-5610 |
| Practice Telephone | 6148787778 |
| Practice Fax Number | 6148782725 |
| Mailing Telephone | 6148787778 |
| Mailing Fax Number | 6148782725 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
30013309 | OH | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | ANTHEM BCBS | 000000116964 | 01 |
| OH | 0417794 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437178548 | Phillip Lane Latham Jr. | Dermatology | 325 Broad Street, Suite 200, Sumter, SC 29150 | 2006-07-19 |
| Street Address |
4488 W BROAD ST |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43228-5610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821338096 | Andre Ballinger | Specialist | 4488 W Broad St, Columbus, OH 43228-5610 | 2013-02-25 |
| 1396005112 | Touch Therapy, LLC | Contractor | 4488 W Broad St, Suite B, Columbus, OH 43228-5610 | 2012-05-26 |
| 1023314903 | Sylvia M Ardis | Marriage & Family Therapist | 4488 W Broad St, Columbus, OH 43228-5610 | 2011-02-09 |
| 1114235678 | Katherine J Tufts | Counselor | 4488 W Broad St, Columbus, OH 43228-5610 | 2010-09-18 |
| 1164741559 | Michael Schaefer | Counselor | 4488 W Broad St, Columbus, OH 43228-5610 | 2010-05-25 |
| 1700011871 | Teresa Smith | Nurse Practitioner | 4488 W Broad St, Columbus, OH 43228-5610 | 2009-05-19 |
| 1477796969 | Jan Holmgren Evans | Counselor | 4488 W Broad St, Columbus, OH 43228-5610 | 2009-04-13 |
| 1215154471 | Mary E Scott M.d Inc. | Family Medicine | 4488 W Broad St, Columbus, OH 43228-5610 | 2007-04-19 |
| 1437215316 | John A Cheek | Dentist | 4488 W Broad St, Columbus, OH 43228-5610 | 2006-12-28 |
| 1356407258 | Mid Ohio Oral Surgery, Inc. | Dentist | 4488 W Broad St, Columbus, OH 43228-5610 | 2006-12-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629694229 | The Laurels of West Columbus, LLC | Skilled Nursing Facility | 441 Norton Rd, Columbus, OH 43228 | 2020-06-19 |
| 1538788146 | Colin Rogers | Student in an Organized Health Care Education/Training Program | Ohiohealth Doctors Hospital, 5100 West Broad Street, Columbus, OH 43228 | 2020-04-14 |
| 1093343899 | Cameron Alvin Gachett | Student in an Organized Health Care Education/Training Program | Ohiohealth Doctors Hospital Community Medicine Clinic, 50 Old Village Road, Columbus, OH 43228 | 2020-03-29 |
| 1407483431 | Zachary Werner | Student in an Organized Health Care Education/Training Program | Ohio Health Doctors Hospital, 5100 West Broad Street, Columbus, OH 43228 | 2020-03-27 |
| 1831684232 | Medcare Clinic LLC | Clinic/Center | 4125 W Broad St, Columbus, OH 43228 | 2018-06-27 |
| 1952893950 | Midland Medical Group, LLC | Family Medicine | 1000 Georgesville Rd, Columbus, OH 43228 | 2018-06-05 |
| 1619478336 | Charles Norris Fennie | Student in an Organized Health Care Education/Training Program | Doctors Hospital Community Medicine Clinic, 50 Old Village Road, Columbus, OH 43228 | 2018-02-27 |
| 1902304389 | Icare Health & Wellness Medical Center, LLC | Counselor | 5152 W.broad St, Suite A, Columbus, OH 43228 | 2018-01-31 |
| 1104334523 | Inner Health Chiropractic, Inc | Chiropractor | 5125 West Broad Street, Inner Health Chiropractic, Columbus, OH 43228 | 2018-01-19 |
| 1205363777 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2182 Dividend Drive, Columbus, OH 43228 | 2017-05-16 |
| Find all providers in zip 43228 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225543515 | Oral & Facial Surgery of East Alabama, LLC | Dentist | 4405 N Stadium Drive, Suite A, Columbus, GA 31909 | 2017-12-08 |
| 1497140719 | Chelsea Elizabeth Johnson | Dentist | 4405 N Stadium Dr Ste A, Columbus, GA 31909-1884 | 2015-04-02 |
| 1275951972 | Oleg Kalsow | Dentist | 300 Hospital Dr Ste 4, Columbus, MS 39705 | 2014-03-31 |
| 1316176944 | Hany Emam | Dentist | 305 W 12th Ave Rm 2110, Columbus, OH 43210-1267 | 2009-07-02 |
| 1720222607 | Matthew Mcdonough | Dentist | 1501 Hilliard Rome Rd, Suite E, Columbus, OH 43228-9544 | 2009-04-23 |
| 1033389382 | Oral & Facial Surgery for Adults & Children LLC | Dentist | 1161 Bethel Rd Suite 303, Columbus, OH 43220-2775 | 2008-03-03 |
| 1003023870 | Columbus Oral & Maxillofacial Surgery PC | Dentist | 4405 N Stadium Dr, Suite A, Columbus, GA 31909-1878 | 2007-05-17 |
| 1629199526 | Rob S. Steiner | Dentist | 5350 E Main St, Columbus, OH 43213-2590 | 2007-04-02 |
| 1104982065 | William Frederick Schultz Jr. | Dentist | 2350 N Park Dr, Columbus, IN 47203-4466 | 2006-12-28 |
| 1326123365 | Kent D Fischvogt | Dentist | 2350 Northpark, Columbus, IN 47203-4466 | 2006-10-26 |
| Find all providers in COLUMBUS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.