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General NPI Number Information
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NPI Number | 1083795272
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Entity Type | Organization
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Legal Business Name | JONATHAN SMALL,M.D., INC.
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 07/15/2011
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Provider Practice Location Address
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Address Line | 8050 HOSBROOK RD SUITE 402
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City | CINCINNATI
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State | OH
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Zip | 45236-2907
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Country | US
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Telephone | 513-794-0083
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Fax | 513-792-3652
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Provider Business Mailing Address
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Address Line | 8050 HOSBROOK SUITE 402
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City | CINCINNATI
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State | OH
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Zip | 45236-2907
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Country | US
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Telephone | 513-794-0083
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Fax | 513-792-3652
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Authorized Official
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Title or Position | PRESIDENT
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Name | JONATHAN SMALL
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Credential | M.D.
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Telephone | 513-794-0083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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