Healthcare Provider Details

I. General information

NPI: 1790871697
Provider Name (Legal Business Name): CURTIS B EVERSON MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 02/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 WEST PLANE ST
BETHEL OH
45106
US

IV. Provider business mailing address

PO BOX 713013
COLUMBUS OH
43271-3013
US

V. Phone/Fax

Practice location:
  • Phone: 513-734-9200
  • Fax: 513-734-9300
Mailing address:
  • Phone: 513-891-7574
  • Fax: 513-793-1032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CURTIS EVERSON
Title or Position: OWNER
Credential: MD
Phone: 513-734-9200