Healthcare Provider Details

I. General information

NPI: 1992625628
Provider Name (Legal Business Name): AUSTIN SAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 OLIN CT
FAIRFIELD OH
45014-6109
US

IV. Provider business mailing address

103 COWAN DR APT 2
MASON OH
45040-2252
US

V. Phone/Fax

Practice location:
  • Phone: 513-889-8477
  • Fax:
Mailing address:
  • Phone: 513-889-8477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: