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General NPI Number Information
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NPI Number | 1982696340
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Entity Type | Individual
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Provider Name | LOREN FORREST HIRATZKA MD
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Gender | Male
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 03/25/2014
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Provider Practice Location Address
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Address Line | 10506 MONTGOMERY RD SUITE 302
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City | CINCINNATI
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State | OH
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Zip | 45242
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Country | US
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Telephone | 513-865-5120
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Fax | 513-865-5121
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Provider Business Mailing Address
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Address Line | 10506 MONTGOMERY ROAD SUITE 302
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City | CINCINNATI
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State | OH
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Zip | 45242
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Country | US
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Telephone | 513-865-5120
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Fax | 513-865-5121
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 25039
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 25039
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35054450H
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | C34038
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 18359
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License Number State | IA
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Taxonomy #6
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 25039
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License Number State | KY
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Taxonomy #7
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 35054450H
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License Number State | OH
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Taxonomy #8
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | C34038
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License Number State | CA
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Taxonomy #9
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 18359
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License Number State | IA
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