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General NPI Number Information
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NPI Number | 1588864938
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Entity Type | Organization
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Legal Business Name | ORTHOCINCY
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 100 ARROW SPRINGS BLVD SUITE 2600
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City | LEBANON
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State | OH
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Zip | 45036-9864
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Country | US
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Telephone | 513-793-3933
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Fax | 513-793-8299
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Provider Business Mailing Address
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Address Line | 560 S LOOP RD
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City | EDGEWOOD
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State | KY
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Zip | 41017
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Country | US
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Telephone | 859-817-7500
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Fax | 859-817-7851
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JOANN M REIS
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Credential |
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Telephone | 517-817-7070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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