Healthcare Provider Details

I. General information

NPI: 1124020904
Provider Name (Legal Business Name): JEFFREY PHILIP MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 02/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 JOSEPH E. SANKER BOULEVARD THE UROLOGY CENTER
CINCINNATI OH
45212
US

IV. Provider business mailing address

200 NORTHLAND BOULEVARD OUTPATIENT ANESTHESIA SPECIALISTS
CINCINNATI OH
45246
US

V. Phone/Fax

Practice location:
  • Phone: 513-841-7600
  • Fax: 513-841-7601
Mailing address:
  • Phone: 513-204-5696
  • Fax: 877-284-4283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35065050
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: