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General NPI Number Information
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NPI Number | 1790013100
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Entity Type | Organization
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Legal Business Name | JULIA KISSEL MD INC.
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Dates
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Enumeration Date | 11/23/2009
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Last Update Date | 11/23/2009
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Provider Practice Location Address
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Address Line | 4555 LAKE FOREST DR STE 580
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City | CINCINNATI
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State | OH
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Zip | 45242-3785
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Country | US
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Telephone | 877-246-5131
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Fax | 877-246-5132
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Provider Business Mailing Address
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Address Line | 4555 LAKE FOREST DR STE 580
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City | CINCINNATI
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State | OH
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Zip | 45242-3785
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Country | US
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Telephone | 877-246-5131
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Fax | 877-246-5132
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Authorized Official
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Title or Position | DIRECTOR
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Name | JULIA KISSEL
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Credential | M.D.
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Telephone | 877-246-5131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35.073799
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License Number State | OH
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