Provider Demographics
NPI:1326041740
Name:REILLY, GERARD P (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:P
Last Name:REILLY
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 1:2060 READING RD
Mailing Address - Street 2:STE 150
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1454
Mailing Address - Country:US
Mailing Address - Phone:513-721-3200
Mailing Address - Fax:513-639-3186
Practice Address - Street 1:9312 WINTON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3978
Practice Address - Country:US
Practice Address - Phone:513-922-0009
Practice Address - Fax:513-931-2481
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35059107207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000020707OtherANTHEM
OH0231627Medicaid
OH160039888OtherMEDICARE RAILROAD
OH988624OtherAETNA
OH0720396OtherUNITED HEALTHCARE
OH288115OtherAMERIGROUP
OH31157505105OtherCARESOURCE
OH000000020707OtherANTHEM
OH160039888OtherMEDICARE RAILROAD
OH0231627Medicaid
OHF47332Medicare UPIN