| |
415 Straight St Cincinnati OH 45219-1060 | |
(513) 559-2580 | |
(513) 559-2596 |
Full Name | |
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Speciality | Family Medicine |
Location | 415 Straight St, Cincinnati, Ohio |
Authorized Official Name and Position | Kelly Bernens (BUSINESS MANAGER PHYSICIAN SERVICES) |
Authorized Official Contact | 5135592891 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Dept 1044 Cincinnati OH 45263-0001 Ph: (513) 557-3330 | 415 Straight St Cincinnati OH 45219-1060 Ph: (513) 559-2580 |
NPI Number | 1578541546 |
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Provider Enumeration Date | 01/09/2006 |
Last Update Date | 02/09/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578541546 | NPI | - | NPPES |
0108136 | Medicaid | OH | |
200067680B | Medicaid | IN | |
65926040 | Medicaid | KY | |
200067680A | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Oki Kidney Care, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4760 E Galbraith Rd, Ste 217, Cincinnati, OH 45236 Phone: 513-842-2000 | |
Uc Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 234 Goodman St, Ml 665x, Cincinnati, OH 45219 Phone: 513-584-7425 Fax: 513-584-8730 |