Provider Demographics
NPI:1083795272
Name:JONATHAN SMALL,M.D., INC.
Entity Type:Organization
Organization Name:JONATHAN SMALL,M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-794-0083
Mailing Address - Street 1:8050 HOSBROOK
Mailing Address - Street 2:SUITE 402
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2907
Mailing Address - Country:US
Mailing Address - Phone:513-794-0083
Mailing Address - Fax:513-792-3652
Practice Address - Street 1:8050 HOSBROOK RD
Practice Address - Street 2:SUITE 402
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2907
Practice Address - Country:US
Practice Address - Phone:513-794-0083
Practice Address - Fax:513-792-3652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty