Healthcare Provider Details

I. General information

NPI: 1609878057
Provider Name (Legal Business Name): ROBERT C GRISCHY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ARROW SPRINGS BLVD SUITE 2700
LEBANON OH
45036-7002
US

IV. Provider business mailing address

100 ARROW SPRINGS BLVD SUITE 2700
LEBANON OH
45036-7002
US

V. Phone/Fax

Practice location:
  • Phone: 513-282-7911
  • Fax: 513-282-7900
Mailing address:
  • Phone: 513-282-7911
  • Fax: 513-282-7900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.054646
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: