Healthcare Provider Details

I. General information

NPI: 1376545590
Provider Name (Legal Business Name): MICHAEL S HALPIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 THOMAS MORE PKWY
CRESTVIEW HILLS KY
41017-3454
US

IV. Provider business mailing address

PO BOX 631662
CINCINNATI OH
45263-1662
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-4525
  • Fax: 859-341-4993
Mailing address:
  • Phone: 859-581-7120
  • Fax: 859-581-7207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number18544
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: