Healthcare Provider Details

I. General information

NPI: 1144923244
Provider Name (Legal Business Name): CHRISTOPHER MEDLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 5 MILE RD STE 100
CINCINNATI OH
45230-2187
US

IV. Provider business mailing address

8000 5 MILE RD STE 100
CINCINNATI OH
45230-2187
US

V. Phone/Fax

Practice location:
  • Phone: 513-624-4500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4631
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: