Provider Demographics
NPI:1710053871
Name:CINCINNATI ENT SPECIALISTS INC
Entity Type:Organization
Organization Name:CINCINNATI ENT SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-451-1544
Mailing Address - Street 1:6040 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-1608
Mailing Address - Country:US
Mailing Address - Phone:513-451-1544
Mailing Address - Fax:513-347-2244
Practice Address - Street 1:8250 WINTON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-5916
Practice Address - Country:US
Practice Address - Phone:513-931-8216
Practice Address - Fax:513-728-3242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2077792Medicaid
OH9926221Medicare ID - Type UnspecifiedMEDICARE LOCATION NO