Healthcare Provider Details

I. General information

NPI: 1336222736
Provider Name (Legal Business Name): L L DEATON MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 AUBURN AVE
CINCINNATI OH
45219-5219
US

IV. Provider business mailing address

PO BOX 635526
CINCINNATI OH
45263-5526
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-3635
  • Fax: 513-585-3189
Mailing address:
  • Phone: 513-891-1006
  • Fax: 513-793-1032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: LOIS L DEATON
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 513-585-3635