Healthcare Provider Details

I. General information

NPI: 1972593234
Provider Name (Legal Business Name): CARDIOLOGY ASSOCIATES OF CINCINNATI, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 07/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3219 CLIFTON AVE SUITE 400
CINCINNATI OH
45220-3027
US

IV. Provider business mailing address

3219 CLIFTON AVE SUITE 400
CINCINNATI OH
45220-3027
US

V. Phone/Fax

Practice location:
  • Phone: 513-861-1260
  • Fax: 513-872-7159
Mailing address:
  • Phone: 513-861-1260
  • Fax: 513-872-7159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DON JANSEN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 513-861-1260