Healthcare Provider Details

I. General information

NPI: 1811142292
Provider Name (Legal Business Name): PATSY LINN PERSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2008
Last Update Date: 11/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3006 PORTSMOUTH AVE
CINCINNATI OH
45208-1510
US

IV. Provider business mailing address

3006 PORTSMOUTH AVE
CINCINNATI OH
45208-1510
US

V. Phone/Fax

Practice location:
  • Phone: 513-871-0684
  • Fax:
Mailing address:
  • Phone: 513-871-0684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35-041105
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: