Healthcare Provider Details

I. General information

NPI: 1366713042
Provider Name (Legal Business Name): ALLIANCE PHYSICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2012
Last Update Date: 02/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 N BROOKWOOD AVE
HAMILTON OH
45013-1209
US

IV. Provider business mailing address

10050 INNOVATION DR SUITE 200
MIAMISBURG OH
45342-4931
US

V. Phone/Fax

Practice location:
  • Phone: 513-896-9700
  • Fax: 513-896-4565
Mailing address:
  • Phone: 937-752-2306
  • Fax: 937-522-7626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY Y KO
Title or Position: CFO
Credential:
Phone: 937-558-3208