Healthcare Provider Details

I. General information

NPI: 1548320864
Provider Name (Legal Business Name): JEFFREY SCOTT DAVIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11125 KENWOOD RD
CINCINNATI OH
45242-1817
US

IV. Provider business mailing address

6461 ASHLEY OAKS CT
WEST CHESTER OH
45069-5111
US

V. Phone/Fax

Practice location:
  • Phone: 513-791-4040
  • Fax:
Mailing address:
  • Phone: 513-779-7159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number35056066
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: