MEDICARE: DR. JACOB KEITH CRITTENDEN III 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
1	208200000X	Plastic Surgery Physician	35.043691	OH
2	208200000X	Plastic Surgery Physician	16223	KY
3	208200000X	Plastic Surgery Physician	ME 86453	FL

General Provider Information

NPI Number	:	1376931105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACOB KEITH CRITTENDEN III MD

Provider Business Mailing Address
First Line	:	621 TUSCULUM AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45226-1771
Country	:	US
Telephone Number	:	702-232-2336
Fax Number	:	702-646-3243

Provider Business Practice Location Address
First Line	:	621 TUSCULUM AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45226-1771
Country	:	US
Telephone Number	:	702-232-2336
Fax Number	:	702-646-3243

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

Provider Enumeration Date	:	01/01/2015
Last Update Date	:	01/01/2015

Similar Medicare Providers

1023997624 — MONICA AMISON
Practice Location Address:

2747 CYPRESS WAY APT 3
CINCINNATI, OH
45212-1771

Practice Phone: 513-806-4647
Practice Fax:

1720968662 — RANAUJAI J MINNIFIELD
Practice Location Address:

530 E EPWORTH AVE
CINCINNATI, OH
45232-1771

Practice Phone: 513-883-0741
Practice Fax:

1790778041 — ONCOLOGY HEMATOLOGY CARE INC
Practice Location Address:

5053 WOOSTER RD
CINCINNATI, OH
45226-2326

Practice Phone: 513-751-2273
Practice Fax: 513-751-2273

1841276441 — MRS. DONNA L MOLONEY D.C
Practice Location Address:

455 DELTA AVE , SUITE 1
CINCINNATI, OH
45226-1127

Practice Phone: 513-321-8484
Practice Fax: 513-321-3676

1275519647 — MR. ERIC W EISELT D.C.
Practice Location Address:

455 DELTA AVE , SUITE 1
CINCINNATI, OH
45226-1127

Practice Phone: 513-321-8484
Practice Fax: 513-321-3676

1629054739 — MR. MARK A. KING D.C.
Practice Location Address:

455 DELTA AVE , SUITE 1
CINCINNATI, OH
45226-1127

Practice Phone: 513-321-8484
Practice Fax: 513-321-3676

Directions to “ DR. JACOB KEITH CRITTENDEN III MD” 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 © 2007-2026 (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.