Healthcare Provider Details

I. General information

NPI: 1225574197
Provider Name (Legal Business Name): DR. TEAGUE AUD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2017
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10766 MONTGOMERY RD
CINCINNATI OH
45242-3213
US

IV. Provider business mailing address

10766 MONTGOMERY RD
CINCINNATI OH
45242-3213
US

V. Phone/Fax

Practice location:
  • Phone: 513-489-3300
  • Fax: 513-489-3018
Mailing address:
  • Phone: 513-489-3300
  • Fax: 513-489-3018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA.01804
License Number StateOH

VIII. Authorized Official

Name: DR. TIMOTHY JOHN TEAGUE
Title or Position: OWNER/AUDIOLOGIST
Credential: AU.D.
Phone: 513-489-3300