MEDICARE: JANA ELYSE HAMBLEY 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	208600000X	Surgery Physician	D84079	MD
2	390200000X	Student in an Organized Health Care Education/Training Program		OH
3	2086S0127X	Trauma Surgery Physician	32.139546	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1760748271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANA ELYSE HAMBLEY MD

Provider Business Mailing Address
First Line	:	2830 VICTORY PARKWAY
Second Line	:	ML 0806
City	:	CINCINNATI
State	:	OH
Zip	:	45206-1785
Country	:	US
Telephone Number	:	513-585-5506
Fax Number	:	513-585-5511

Provider Business Practice Location Address
First Line	:	222 PIEDMONT AVENUE
Second Line	:	SUITE 7000
City	:	CINCINNATI
State	:	OH
Zip	:	45219-4224
Country	:	US
Telephone Number	:	513-475-8787
Fax Number	:	513-475-7348

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

Provider Enumeration Date	:	04/09/2012
Last Update Date	:	10/13/2021

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