Healthcare Provider Details

I. General information

NPI: 1124278809
Provider Name (Legal Business Name): D. BRADLEY BOBBITT MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9157 MONTGOMERY RD SUITE 101
CINCINNATI OH
45242-7731
US

IV. Provider business mailing address

9157 MONTGOMERY RD SUITE 101
CINCINNATI OH
45242-7731
US

V. Phone/Fax

Practice location:
  • Phone: 513-936-8777
  • Fax: 513-936-8778
Mailing address:
  • Phone: 513-936-8777
  • Fax: 513-936-8778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number35079259
License Number StateOH

VIII. Authorized Official

Name: DR. DAVID BRADLEY BOBBITT
Title or Position: OWNER
Credential: M.D.
Phone: 513-936-8777