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General NPI Number Information
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NPI Number | 1265799498
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Entity Type | Individual
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Provider Name | BRET EDWARD BETZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | 4777 E GALBRAITH RD EMERGENCY MEDICINE
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City | CINCINNATI
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State | OH
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Zip | 45236-2725
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Country | US
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Telephone | 513-558-5281
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Fax | 513-558-5791
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Provider Business Mailing Address
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Address Line | PO BOX 636256 CENTRAL CREDENTIALING
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City | CINCINNATI
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State | OH
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Zip | 45263-6256
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Country | US
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Telephone | 513-585-5505
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Fax | 513-585-5511
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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 | 207PS0010X
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Taxonomy Name | Sports Medicine (Emergency Medicine) Physician
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License Number | 35.125633
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 35125633
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License Number State | OH
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