Healthcare Provider Details
I. General information
NPI: 1831204346
Provider Name (Legal Business Name): KAGAN OZER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/21/2006
Last Update Date: 11/04/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3188 BELLEVUE AVENUE
CINCINNATI OH
45219-2364
US
IV. Provider business mailing address
PO BOX 636256
CINCINNATI OH
45263-6256
US
V. Phone/Fax
- Phone: 513-475-8690
- Fax: 513-475-7593
- Phone: 513-585-5506
- Fax: 513-585-5511
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 41918 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 4301098609 |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | 4301098609 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: