Healthcare Provider Details
I. General information
NPI: 1053344226
Provider Name (Legal Business Name): CINCINNATI HEALTHCARE GROUP PSC, DBA PATIENT FIRST PHYSICIANS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/09/2006
Last Update Date: 10/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6159 1ST FINANCIAL DR
BURLINGTON KY
41005-7892
US
IV. Provider business mailing address
334 THOMAS MORE PKWY SUITE 200
CRESTVIEW HILLS KY
41017-3464
US
V. Phone/Fax
- Phone: 859-586-8200
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 33140 |
| License Number State | KY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
KEN
FOLZ
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 859-957-1080