MEDICARE: JOSEPH A CREEVY 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	208800000X	Urology Physician	35-03-1750	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	340011125	OTHER	KY	RAILROAD MEDICARE
2	P00013184	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1700828449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH A CREEVY MD

Provider Business Mailing Address
First Line	:	4700 SMITH RD
Second Line	:	SUITE L
City	:	CINCINNATI
State	:	OH
Zip	:	45212-2787
Country	:	US
Telephone Number	:	513-366-4000
Fax Number	:	513-366-4001

Provider Business Practice Location Address
First Line	:	4700 SMITH RD
Second Line	:	SUITE L
City	:	CINCINNATI
State	:	OH
Zip	:	45212-2787
Country	:	US
Telephone Number	:	513-366-4000
Fax Number	:	513-366-4001

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

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	06/09/2008

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Directions to “ JOSEPH A CREEVY MD” Practice Location

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