Provider Demographics
NPI:1609873827
Name:YUELLIG, THOMAS RIES (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:RIES
Last Name:YUELLIG
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 1:5885 HARRISON AVE
Mailing Address - Street 2:SUITE 3500
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-1651
Mailing Address - Country:US
Mailing Address - Phone:513-922-9660
Mailing Address - Fax:513-347-2347
Practice Address - Street 1:5885 HARRISON AVE
Practice Address - Street 2:SUITE 3500
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-1651
Practice Address - Country:US
Practice Address - Phone:513-922-9660
Practice Address - Fax:513-347-2347
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35053954207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0753653Medicaid
OHYU0632154Medicare PIN
OHYU0632154Medicare PIN
KY64062151Medicaid