Provider Demographics
NPI:1548256902
Name:FORTE, THOMAS EDWARD (DO)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:EDWARD
Last Name:FORTE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:579 LAKERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-2704
Mailing Address - Country:US
Mailing Address - Phone:513-522-1986
Mailing Address - Fax:513-522-1992
Practice Address - Street 1:11260 CHESTER RD
Practice Address - Street 2:SUITE 530
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4048
Practice Address - Country:US
Practice Address - Phone:513-549-3004
Practice Address - Fax:513-522-1992
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.0025222083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0405770Medicaid
OH0405770Medicaid
OHB95936Medicare UPIN