Provider Demographics
NPI:1790251411
Name:GEHRING, LOUIS EDWARD III
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:EDWARD
Last Name:GEHRING
Suffix:III
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 1:11459 GRAVENHURST DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-1234
Mailing Address - Country:US
Mailing Address - Phone:513-885-7286
Mailing Address - Fax:
Practice Address - Street 1:11459 GRAVENHURST DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-1234
Practice Address - Country:US
Practice Address - Phone:513-885-7286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2225890374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2225890Medicaid