MEDICARE: CYNTHIA D OKOT-KOTBER 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207V00000X	Obstetrics & Gynecology Physician	35.149062	OH

General Provider Information

NPI Number	:	1477116333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA D OKOT-KOTBER MD

Provider Business Mailing Address
First Line	:	4030 SMITH RD STE 425
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1931
Country	:	US
Telephone Number	:	513-731-1550
Fax Number	:	513-731-9836

Provider Business Practice Location Address
First Line	:	4030 SMITH RD STE 425
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1931
Country	:	US
Telephone Number	:	513-731-1550
Fax Number	:	513-731-9836

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

Provider Enumeration Date	:	04/17/2019
Last Update Date	:	08/31/2023

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