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General NPI Number Information
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NPI Number | 1073784765
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Entity Type | Organization
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Legal Business Name | ALLIANCE PRIMARY CARE
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Dates
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Enumeration Date | 03/20/2008
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 3805 EDWARDS RD STE. 300
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City | CINCINNATI
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State | OH
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Zip | 45209-1900
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Country | US
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Telephone | 513-585-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 3200 BURNET AVE 1 RIDGEWAY
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City | CINCINNATI
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State | OH
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Zip | 45229-3019
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Country | US
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Telephone | 513-585-9009
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Fax | 513-585-9373
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Authorized Official
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Title or Position | SENIOR DIRECTOR OF PATIENT ACCOUNTS
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Name | JAMES LARSON
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Credential |
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Telephone | 513-585-9336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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