MEDICARE: DR. JON E MENDELSOHN MD FACS

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	2082S0099X	Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician	35071983	OH

General Provider Information

NPI Number	:	1194874149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JON E MENDELSOHN MD FACS

Provider Business Mailing Address
First Line	:	3805 EDWARDS RD
Second Line	:	SUITE 100
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1900
Country	:	US
Telephone Number	:	513-351-3223
Fax Number	:	513-396-8995

Provider Business Practice Location Address
First Line	:	3805 EDWARDS RD
Second Line	:	SUITE 100
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1900
Country	:	US
Telephone Number	:	513-351-3223
Fax Number	:	513-396-8995

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. JON E MENDELSOHN MD FACS” Practice Location

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