Healthcare Provider Details

I. General information

NPI: 1134712896
Provider Name (Legal Business Name): DR. ABDUL RAHMAN JAZIEH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2021
Last Update Date: 02/14/2021
Certification Date: 02/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4746 MONTGOMERY RD STE 201
CINCINNATI OH
45212-2628
US

IV. Provider business mailing address

4746 MONTGOMERY RD STE 201
CINCINNATI OH
45212-2628
US

V. Phone/Fax

Practice location:
  • Phone: 513-731-2273
  • Fax:
Mailing address:
  • Phone: 513-731-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number35.078102
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number35.078102
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: