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General NPI Number Information
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NPI Number | 1497934087
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Entity Type | Organization
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Legal Business Name | BETSY BROGAN DPM INC
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 5520 HARRISON AVE SUITE 2
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City | CINCINNATI
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State | OH
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Zip | 45248-2362
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Country | US
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Telephone | 513-598-8324
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Fax | 513-598-8327
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Provider Business Mailing Address
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Address Line | 5520 HARRISON AVE SUITE 2
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City | CINCINNATI
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State | OH
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Zip | 45248-2362
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Country | US
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Telephone | 513-598-8324
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Fax | 513-598-8327
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Authorized Official
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Title or Position | OWNER
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Name | DR. BETSY A BROGAN
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Credential | D.P.M.
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Telephone | 513-598-8324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 36-00-3262B
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License Number State | OH
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