Healthcare Provider Details

I. General information

NPI: 1851728810
Provider Name (Legal Business Name): ALLIANCE PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2013
Last Update Date: 10/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 CEREAL AVE SUITE 100
HAMILTON OH
45013-2784
US

IV. Provider business mailing address

1 PRESTIGE PL SUITE 550
MIAMISBURG OH
45342-3794
US

V. Phone/Fax

Practice location:
  • Phone: 513-867-3166
  • Fax: 513-867-2056
Mailing address:
  • Phone: 937-752-2305
  • Fax: 937-522-7513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY Y KO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 937-558-3223