Healthcare Provider Details
I. General information
NPI: 1336582014
Provider Name (Legal Business Name): MERCY EMERGENCY PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/11/2013
Last Update Date: 04/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4101 EDWARDS RD
CINCINNATI OH
45209-1609
US
IV. Provider business mailing address
4750 HEMPSTEAD STATION DR
KETTERING OH
45429-5164
US
V. Phone/Fax
- Phone: 800-875-0136
- Fax: 937-619-4150
- Phone: 800-875-0136
- Fax: 937-619-4150
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
WILLIAM
COLE
JR.
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 800-875-0136