Healthcare Provider Details

I. General information

NPI: 1134346521
Provider Name (Legal Business Name): SPRINGDALE FAMILY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 W SHARON RD
CINCINNATI OH
45246-4137
US

IV. Provider business mailing address

212 W SHARON RD
CINCINNATI OH
45246-4137
US

V. Phone/Fax

Practice location:
  • Phone: 513-771-7213
  • Fax: 513-771-4356
Mailing address:
  • Phone: 513-771-7213
  • Fax: 513-771-4356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BARRY W. WEBB
Title or Position: PARTNER
Credential: M.D.
Phone: 513-771-7213