Provider Demographics
NPI:1033227780
Name:FEIBEL, JOHN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:FEIBEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4805 MONTGOMERY RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2198
Mailing Address - Country:US
Mailing Address - Phone:513-961-5558
Mailing Address - Fax:513-961-1912
Practice Address - Street 1:4805 MONTGOMERY RD
Practice Address - Street 2:SUITE 410
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2198
Practice Address - Country:US
Practice Address - Phone:513-241-2370
Practice Address - Fax:513-241-6053
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0473682084N0400X
KY156932084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OC02103OtherNATIONWIDE PROVIDER #
2074981OtherAETNA PROVIDER NUMBER
KY64781271Medicaid
1837192-001OtherCIGNA PROVIDER NUMBER
311412447027OtherCARESOURCE PROVIDER NUMBE
05-20121OtherUNITED HEALTHCARE PROVIDE
IN100357150AMedicaid
000000019798OtherANTHEM PROVIDER NUMBER
OH0490768Medicaid
05-20121OtherUNITED HEALTHCARE PROVIDE
130017462Medicare ID - Type UnspecifiedRAILROAD MEDICARE
000000019798OtherANTHEM PROVIDER NUMBER
OHFE0512992Medicare ID - Type Unspecified