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NPI Code Detail

MEDICARE: DR. DOUGLAS J MCKIMM MD

MEDICARE:  DR. DOUGLAS J MCKIMM  MD
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
1207P00000XEmergency Medicine Physician35047673OH

Other Identifiers

General Provider Information

NPI Number : 1265436869
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS J MCKIMM MD
Provider Business Mailing Address
First Line : 1472 SOLUTIONS CTR
Second Line :
City : CHICAGO
State : IL
Zip : 60677-1004
Country : US
Telephone Number : 513-557-3333
Fax Number : 513-557-3332
Provider Business Practice Location Address
First Line : 3131 QUEEN CITY AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-2316
Country : US
Telephone Number : 513-557-3333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 06/19/2008

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Directions to “ DR. DOUGLAS J MCKIMM MD” Practice Location

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