Healthcare Provider Details

I. General information

NPI: 1124061494
Provider Name (Legal Business Name): BETHESDA FAMILY PRACTICE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 03/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 W LEXINGTON STE 100
CINCINNATI OH
45212-3667
US

IV. Provider business mailing address

1775 W LEXINGTON STE 100
CINCINNATI OH
45212-3667
US

V. Phone/Fax

Practice location:
  • Phone: 513-977-6700
  • Fax: 513-531-2624
Mailing address:
  • Phone: 513-977-6700
  • Fax: 513-531-2624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LINDA ESTEP
Title or Position: MANAGER
Credential:
Phone: 513-977-6715