Healthcare Provider Details

I. General information

NPI: 1063493948
Provider Name (Legal Business Name): OHIO VALLEY ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 QUEEN CITY AVE OHIO VALLEY ANESTHESIA LLC
CINCINNATI OH
45238-2316
US

IV. Provider business mailing address

PO BOX 70-1618
CINCINNATI OH
45270-1618
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-7246
  • Fax: 859-341-7867
Mailing address:
  • Phone: 859-341-7246
  • Fax: 859-341-7867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: LEE STACY MEGOIS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 859-341-7246