Healthcare Provider Details

I. General information

NPI: 1245573591
Provider Name (Legal Business Name): JAY N NATHWANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 BURNET AVE
CINCINNATI OH
45229-3019
US

IV. Provider business mailing address

600 HIGHLAND AVE # H4831
MADISON WI
53792-0001
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8787
  • Fax: 513-929-7239
Mailing address:
  • Phone: 608-263-1377
  • Fax:

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 State
# 2
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number35.138938
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: