Healthcare Provider Details

I. General information

NPI: 1235455833
Provider Name (Legal Business Name): MATTHEW SCOTT HENSLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2010
Last Update Date: 10/23/2020
Certification Date: 10/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 AUBURN AVE SUITE 209
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

237 WILLIAM HOWARD TAFT 2ND FL, CBO2-3, ATTN: CREDENTIALING
CINCINNATI OH
45219-2906
US

V. Phone/Fax

Practice location:
  • Phone: 513-421-5558
  • Fax:
Mailing address:
  • Phone: 513-263-8571
  • Fax: 513-366-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number47935
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number35.120373
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: