Healthcare Provider Details

I. General information

NPI: 1346373503
Provider Name (Legal Business Name): RICHARD A JOLSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 PIEDMONT AVE SUITE 2200
CINCINNATI OH
45219-4231
US

IV. Provider business mailing address

222 PIEDMONT AVE SUITE 2200
CINCINNATI OH
45219-4231
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8690
  • Fax: 513-475-7243
Mailing address:
  • Phone: 513-475-8690
  • Fax: 513-475-7243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35.024113
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: