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General NPI Number Information
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NPI Number | 1245091537
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Entity Type | Individual
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Provider Name | MR. DARIUS RANDELL BOLLING
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Gender | Male
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Dates
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Enumeration Date | 01/23/2024
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 3188 BELLEVUE AVE
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City | CINCINNATI
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State | OH
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Zip | 45219-2369
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Country | US
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Telephone | 513-584-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 11140 HUTCHESON ALY
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City | SPRINGDALE
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State | OH
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Zip | 45246-3770
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Country | US
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Telephone | 214-385-1754
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN.529815
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License Number State | OH
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