Healthcare Provider Details

I. General information

NPI: 1649253469
Provider Name (Legal Business Name): JOHN W NURRE II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 06/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6949 GOOD SAMARITAN DRIVE STE 200
CINCINNATI OH
45247-5206
US

IV. Provider business mailing address

4685 FOREST AVE STE C
CINCINNATI OH
45212-3359
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-7000
  • Fax: 513-246-8855
Mailing address:
  • Phone: 513-246-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number35053595
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number35.053595
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: