Healthcare Provider Details

I. General information

NPI: 1225067184
Provider Name (Legal Business Name): FIVE MILE MEDICAL ARTS ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 04/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10945 REED HARTMAN HWY SUITE 209
CINCINNATI OH
45242-2828
US

IV. Provider business mailing address

10945 REED HARTMAN HWY SUITE 209
CINCINNATI OH
45242-2828
US

V. Phone/Fax

Practice location:
  • Phone: 513-474-8500
  • Fax:
Mailing address:
  • Phone: 513-474-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number35.038518
License Number StateOH

VIII. Authorized Official

Name: DR. JAMES J. KREINDLER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 513-474-8500