Healthcare Provider Details

I. General information

NPI: 1982605754
Provider Name (Legal Business Name): KATHRYN A WEICHERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 12/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 AUBURN AVE
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

6463 TAYLOR MILL RD
INDEPENDENCE KY
41051-9392
US

V. Phone/Fax

Practice location:
  • Phone: 513-651-9660
  • Fax: 513-241-2962
Mailing address:
  • Phone: 859-363-4983
  • Fax: 513-241-2962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number35035158
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35035158
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: