| |
119 W Kemper Rd, Cincinnati, OH 45246-2511 | |
(513) 671-6112 | |
(513) 671-6386 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 119 W Kemper Rd, Cincinnati, Ohio |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295875722 | NPI | - | NPPES |
2032508 | Medicaid | OH | |
65928707 | Medicaid | KY | |
77902757 | Medicaid | KY | |
2032491 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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4452 Eastgate Blvd, Suite 305, Cincinnati, OH 45245-1584 Ph: (513) 752-5700 | 119 W Kemper Rd, Cincinnati, OH 45246-2511 Ph: (513) 671-6112 |