Healthcare Provider Details

I. General information

NPI: 1164170064
Provider Name (Legal Business Name): EMILY CAMPBELL SIZER PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY CAMPBELL HEUCK

II. Dates (important events)

Enumeration Date: 03/10/2022
Last Update Date: 03/10/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7661 BEECHMONT AVE STE 120
CINCINNATI OH
45255-4234
US

IV. Provider business mailing address

7661 BEECHMONT AVE STE 120
CINCINNATI OH
45255-4234
US

V. Phone/Fax

Practice location:
  • Phone: 513-231-9010
  • Fax:
Mailing address:
  • Phone: 513-231-9010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.007487RX
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number50.007487RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: