MEDICARE: CARL JACK FICHTENBAUM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35-076757	OH
2	207RI0200X	Infectious Disease Physician	35-076757	OH
3	208000000X	Pediatrics Physician	35-076757	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	010064796	OTHER	OH	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073578951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARL JACK FICHTENBAUM M.D.

Provider Business Mailing Address
First Line	:	2830 VICTORY PKWY
Second Line	:	STE 310
City	:	CINCINNATI
State	:	OH
Zip	:	45206-3700
Country	:	US
Telephone Number	:	513-245-3444
Fax Number	:	513-245-3449

Provider Business Practice Location Address
First Line	:	200 ALBERT SABIN WAY
Second Line	:	# 405
City	:	CINCINNATI
State	:	OH
Zip	:	45267-2800
Country	:	US
Telephone Number	:	513-584-6977
Fax Number	:	513-584-6040

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	03/27/2014

Similar Medicare Providers

1750244141 — EBTISAM HAMDAN AL MAAMARI MD
Practice Location Address:

200 ALBERT SABIN WAY
CINCINNATI, OH
45267-2800

Practice Phone: 513-584-2586
Practice Fax: 513-584-2175

1851519946 — MRS. MICHELLE NICOLE DWERTMAN MSPT
Practice Location Address:

200 ALBERT SABIN WAY STE 1200
CINCINNATI, OH
45267-2800

Practice Phone: 513-475-8881
Practice Fax:

1396941100 — DR. WHITNEY K BRYANT MD, MPH
Practice Location Address:

234 ALBERT SABIN WAY , EMERGENCY MEDICINE DEPARTMENT
CINCINNATI, OH
45267-2800

Practice Phone: 513-558-5281
Practice Fax: 513-558-5791

1265827588 — DR. TODD MICHAEL JACOBS DMD
Practice Location Address:

200 ALBERT SABIN WAY
CINCINNATI, OH
45267-2800

Practice Phone: 859-394-2899
Practice Fax:

1689216467 — MEGAN FERRELL OTR/L
Practice Location Address:

200 ALBERT SABIN WAY
CINCINNATI, OH
45267-2800

Practice Phone: 513-475-8000
Practice Fax:

1851983027 — REBEKAH LYNN GLADDEN OTR/L
Practice Location Address:

206 ALBERT SABIN WAY
CINCINNATI, OH
45267-2800

Practice Phone: 513-221-0325
Practice Fax:

Directions to “ CARL JACK FICHTENBAUM M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.