Healthcare Provider Details

I. General information

NPI: 1619136082
Provider Name (Legal Business Name): CAROLINE CRIAG BILLINGSLEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 02/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 AUBURN AVE
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

237 WILLIAM HOWARD TAFT, PHYS DIV 2ND FL, CBO2-3, ATTN: CREDENTIALING
CINCINNATI OH
45219-2906
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-2323
  • Fax: 513-585-4893
Mailing address:
  • Phone: 513-263-8571
  • Fax: 513-366-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number35.099032
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberLL30774
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: