Provider Demographics
NPI:1861889636
Name:UNIVERSITY OF CINCINNATI PHYSICIANS COMPANY
Entity type:Organization
Organization Name:UNIVERSITY OF CINCINNATI PHYSICIANS COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EDBA
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAFLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-475-8015
Mailing Address - Street 1:2900 VERNON PL
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2436
Mailing Address - Country:US
Mailing Address - Phone:513-803-6000
Mailing Address - Fax:513-475-8020
Practice Address - Street 1:2900 VERNON PL
Practice Address - Street 2:SUITE 2100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2436
Practice Address - Country:US
Practice Address - Phone:513-803-6000
Practice Address - Fax:513-475-8020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty