Provider Demographics
NPI:1033108592
Name:CEI PHYSICIANS PSC LLC
Entity Type:Organization
Organization Name:CEI PHYSICIANS PSC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE CREDENTIALS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERI
Authorized Official - Middle Name:J
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-3741
Mailing Address - Street 1:1945 CEI DR
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5664
Mailing Address - Country:US
Mailing Address - Phone:513-569-3741
Mailing Address - Fax:513-569-3941
Practice Address - Street 1:580 S LOOP RD
Practice Address - Street 2:SUITE 200
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017
Practice Address - Country:US
Practice Address - Phone:859-331-9000
Practice Address - Fax:859-331-9040
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CEI PHYSICIANS PSC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-18
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6592833500Medicaid
IN100004440DMedicaid
OH2215721Medicaid
KYCC6633OtherRAILROAD MEDICARE