Healthcare Provider Details

I. General information

NPI: 1164954830
Provider Name (Legal Business Name): STEPHANIE A O'ROURKE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11643 SOLZMAN RD
CINCINNATI OH
45249-1232
US

IV. Provider business mailing address

11643 SOLZMAN RD
CINCINNATI OH
45249-1232
US

V. Phone/Fax

Practice location:
  • Phone: 513-530-0200
  • Fax: 513-530-0730
Mailing address:
  • Phone: 513-530-0200
  • Fax: 513-530-0730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.138580
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: