Provider Demographics
NPI:1356393649
Name:BRUCE, JEREMY E (MD)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:E
Last Name:BRUCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:237 WILLIAM HOWARD TAFT RD STE 440
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2610
Mailing Address - Country:US
Mailing Address - Phone:513-351-9900
Mailing Address - Fax:513-366-4491
Practice Address - Street 1:7310 TURFWAY RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1385
Practice Address - Country:US
Practice Address - Phone:859-282-4480
Practice Address - Fax:859-282-4495
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2025-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35.081143207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0735682Medicaid
H97657Medicare UPIN
OHST0610755Medicare PIN