Healthcare Provider Details

I. General information

NPI: 1710959333
Provider Name (Legal Business Name): JAYSON ROLAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 W GALBRAITH RD STE 220
CINCINNATI OH
45231-6002
US

IV. Provider business mailing address

740 W GALBRAITH RD STE 220
CINCINNATI OH
45231-6002
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-7337
  • Fax: 513-522-6147
Mailing address:
  • Phone: 513-246-7337
  • Fax: 513-522-6147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number219440-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.137998
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: