Healthcare Provider Details

I. General information

NPI: 1942203377
Provider Name (Legal Business Name): CURTIS B EVERSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 S EDWIN C MOSES BLVD
DAYTON OH
45417-3462
US

IV. Provider business mailing address

4600 MONTGOMERY RD STE 400
CINCINNATI OH
45212-2600
US

V. Phone/Fax

Practice location:
  • Phone: 513-734-9200
  • Fax:
Mailing address:
  • Phone: 833-510-4357
  • Fax: 513-734-9300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35-063130
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number35.063130
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number35.063130
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: