MEDICARE: UNIVERSITY OF CINCINNATI PHYSICIANS COMPANY

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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1861889636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY OF CINCINNATI PHYSICIANS COMPANY

Provider Business Mailing Address
First Line	:	2900 VERNON PL
Second Line	:	SUITE 2100
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2436
Country	:	US
Telephone Number	:	513-803-6000
Fax Number	:	513-475-8020

Provider Business Practice Location Address
First Line	:	2900 VERNON PL
Second Line	:	SUITE 2100
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2436
Country	:	US
Telephone Number	:	513-803-6000
Fax Number	:	513-475-8020

Authorized Official
Title or Position	:	EDBA
Name	:	TIM HAFLEY
Credential	:
Telephone Number	:	513-475-8015

Provider Enumeration Date	:	04/20/2015
Last Update Date	:	04/20/2015

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