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NPI Code Detail

MEDICARE: BRIAN P CLYMER DO

MEDICARE: BRIAN P CLYMER DO
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
1207R00000XInternal Medicine Physician34-007511OH

Other Identifiers

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

General Provider Information

NPI Number : 1619905635
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN P CLYMER DO
Provider Business Mailing Address
First Line : PO BOX 636256
Second Line : CENTRAL CREDENTIALING
City : CINCINNATI
State : OH
Zip : 45263-6256
Country : US
Telephone Number : 513-558-5505
Fax Number : 513-585-5511
Provider Business Practice Location Address
First Line : 231 ALBERT SABIN WAY
Second Line : ML 0769
City : CINCINNATI
State : OH
Zip : 45267-2827
Country : US
Telephone Number : 513-558-5281
Fax Number : 513-558-5791
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2006
Last Update Date : 06/15/2017

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