Healthcare Provider Details

I. General information

NPI: 1972593762
Provider Name (Legal Business Name): ROGER VINCENT MEYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 VINE ST VA MEDICAL CENTER
CINCINNATI OH
45220-2213
US

IV. Provider business mailing address

628 OVERTON ST
NEWPORT KY
41071-2010
US

V. Phone/Fax

Practice location:
  • Phone: 513-861-3100
  • Fax: 513-662-1854
Mailing address:
  • Phone: 859-431-1974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35-03-1119
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: