Healthcare Provider Details

I. General information

NPI: 1639461882
Provider Name (Legal Business Name): ERIK MATTHEW DUNKI-JACOBS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2011
Last Update Date: 08/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

379 DIXMYTH AVE
CINCINNATI OH
45220-2475
US

IV. Provider business mailing address

4685 FOREST AVE STE C
CINCINNATI OH
45212-3359
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-7000
  • Fax: 513-246-7590
Mailing address:
  • Phone: 513-246-7796
  • Fax: 513-852-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number35.121395
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35.121395
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: