Healthcare Provider Details

I. General information

NPI: 1942279153
Provider Name (Legal Business Name): MONICA A FLYNN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3802 PAXTON AVE SUITE 1
CINCINNATI OH
45209-2399
US

IV. Provider business mailing address

3143 MARKBREIT AVE
CINCINNATI OH
45209-1732
US

V. Phone/Fax

Practice location:
  • Phone: 513-289-5009
  • Fax: 513-871-7797
Mailing address:
  • Phone: 513-289-5009
  • Fax: 513-871-7797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35064363
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number44494
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: