Healthcare Provider Details

I. General information

NPI: 1720460827
Provider Name (Legal Business Name): ALI KORD M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2015
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

921 S OAKLEY BLVD FL 2
CHICAGO IL
60612-4229
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-4391
  • Fax:
Mailing address:
  • Phone: 646-675-0212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number25IA12333400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number35.141035
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: