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General NPI Number Information
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NPI Number | 1548386865
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Entity Type | Organization
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Legal Business Name | OVER-THE-RHINE MEDICENTER, LTD.
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 308 READING RD FL 1B
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City | CINCINNATI
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State | OH
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Zip | 45202-1369
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Country | US
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Telephone | 513-241-5234
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Fax | 513-241-5241
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Provider Business Mailing Address
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Address Line | 308 READING RD FL 1B
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City | CINCINNATI
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State | OH
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Zip | 45202-1369
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Country | US
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Telephone | 513-241-5234
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Fax | 513-241-5241
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Authorized Official
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Title or Position | OWNER-PHYSICIAN
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Name | DR. DOUGLAS E CHICCHON
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Credential | M.D.
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Telephone | 513-241-5234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 35035817
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License Number State | OH
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