Provider Demographics
NPI:1003993346
Name:RODNEY E. VIVIAN MD INC
Entity Type:Organization
Organization Name:RODNEY E. VIVIAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:S
Authorized Official - Last Name:DRIGGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-232-3070
Mailing Address - Street 1:8000 5 MILE RD
Mailing Address - Street 2:240
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2163
Mailing Address - Country:US
Mailing Address - Phone:513-232-3070
Mailing Address - Fax:513-232-5794
Practice Address - Street 1:8000 5 MILE RD
Practice Address - Street 2:240
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2163
Practice Address - Country:US
Practice Address - Phone:513-232-3070
Practice Address - Fax:513-232-5794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
196047000OtherMAGELLAN
=========OtherMEDICAL MUTUAL
196047000OtherMAGELLAN