Provider Demographics
NPI:1497127682
Name:HITCHCOCK, BRIAN
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:HITCHCOCK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10615 MONTGOMERY RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:MONTGOMERY
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4461
Mailing Address - Country:US
Mailing Address - Phone:513-475-3180
Mailing Address - Fax:513-475-3580
Practice Address - Street 1:10615 MONTGOMERY RD
Practice Address - Street 2:SUITE 150
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4461
Practice Address - Country:US
Practice Address - Phone:513-475-3180
Practice Address - Fax:513-475-3580
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other