Healthcare Provider Details

I. General information

NPI: 1295730588
Provider Name (Legal Business Name): JOEL I SORGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 09/22/2020
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

463 OHIO PIKE STE 201
CINCINNATI OH
45255-3744
US

IV. Provider business mailing address

6480 HARRISON AVE STE 201
CINCINNATI OH
45247-7961
US

V. Phone/Fax

Practice location:
  • Phone: 513-354-3700
  • Fax: 513-528-1209
Mailing address:
  • Phone: 513-354-7785
  • Fax: 513-354-7651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35293
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35-06-4933-S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: