Healthcare Provider Details

I. General information

NPI: 1407874282
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: 07/18/2006
Last Update Date: 04/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13260 SERVICE RD
WALTON KY
41094-9565
US

IV. Provider business mailing address

334 THOMAS MORE PKWY SUITE 200
CRESTVIEW HILLS KY
41017-3464
US

V. Phone/Fax

Practice location:
  • Phone: 859-485-4116
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22966
License Number StateKY

VIII. Authorized Official

Name: MR. KEN FOLZ
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 859-957-1080