Healthcare Provider Details
I. General information
NPI: 1922031020
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
125 ST. MICHAEL DRIVE
COLD SPRING KY
41076-9999
US
IV. Provider business mailing address
334 THOMAS MORE PKWY SUITE 200
CRESTVIEW HILLS KY
41017-3464
US
V. Phone/Fax
- Phone: 859-781-4111
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 18151 |
| License Number State | KY |
VIII. Authorized Official
Name: MR.
KEN
FOLZ
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 859-957-1080