Provider Demographics
NPI:1508848706
Name:DRS ABRAHAMSON
Entity Type:Organization
Organization Name:DRS ABRAHAMSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:IRA
Authorized Official - Last Name:ABRAHAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-621-2445
Mailing Address - Street 1:105 W 4TH ST
Mailing Address - Street 2:STE 719
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-2712
Mailing Address - Country:US
Mailing Address - Phone:513-621-2445
Mailing Address - Fax:513-621-2513
Practice Address - Street 1:105 W 4TH ST
Practice Address - Street 2:STE 719
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-2712
Practice Address - Country:US
Practice Address - Phone:513-621-2445
Practice Address - Fax:513-621-2513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AB9268161Medicare ID - Type UnspecifiedGROUP #