Provider Demographics
NPI:1225071368
Name:AUSTIN, JOE N (MD)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:N
Last Name:AUSTIN
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 1:2123 AUBURN AVE
Mailing Address - Street 2:#404
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:513-241-5630
Mailing Address - Fax:513-241-7146
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:#404
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-241-5630
Practice Address - Fax:513-241-7146
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35062517207RN0300X
KY28464207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH390005424OtherMEDICARE RR
KY64869332Medicaid
IN200069950Medicaid
OH0852680Medicaid
IN200069950Medicaid
KY0514407Medicare PIN
OH390005424OtherMEDICARE RR