MEDICARE: DR. JOHN SCOTT CARDONE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207NS0135X	Procedural Dermatology Physician	35-058847	OH
2	207N00000X	Dermatology Physician	35-058847	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01504660	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	000000936526	OTHER	OH	ANTHEM BC/BS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275526915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN SCOTT CARDONE M.D.

Provider Business Mailing Address
First Line	:	5300 FAR HILLS AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45429-2381
Country	:	US
Telephone Number	:	937-433-7536
Fax Number	:	937-433-9612

Provider Business Practice Location Address
First Line	:	5885 HARRISON AVE
Second Line	:	SUITE 3900
City	:	CINCINNATI
State	:	OH
Zip	:	45248-1691
Country	:	US
Telephone Number	:	513-662-2500
Fax Number	:	513-662-2511

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	06/08/2017

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Directions to “ DR. JOHN SCOTT CARDONE M.D.” Practice Location

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