Healthcare Provider Details

I. General information

NPI: 1801123211
Provider Name (Legal Business Name): REBECCA CAVEY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2009
Last Update Date: 11/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 N HIGH ST
HILLSBORO OH
45133-8273
US

IV. Provider business mailing address

7050 MORRIS RD
HAMILTON OH
45011-5426
US

V. Phone/Fax

Practice location:
  • Phone: 937-393-6100
  • Fax: 937-619-4050
Mailing address:
  • Phone: 937-619-4015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number50.002979
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: