Healthcare Provider Details

I. General information

NPI: 1255768107
Provider Name (Legal Business Name): SOUTHWEST OHIO ANESTHESIA CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2013
Last Update Date: 01/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4415 AICHOLTZ RD
CINCINNATI OH
45245-1506
US

IV. Provider business mailing address

4665 CORNELL RD STE 119
BLUE ASH OH
45241-2455
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-7246
  • Fax: 859-341-7867
Mailing address:
  • Phone: 513-265-5989
  • Fax:

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 STEPHEN MEGOIS
Title or Position: PRESIDENT
Credential: MD
Phone: 859-341-7246