Provider Demographics
NPI:1831114388
Name:SPIELDOCH, RISA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:RISA
Middle Name:LYNN
Last Name:SPIELDOCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8094 BEECHMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3145
Mailing Address - Country:US
Mailing Address - Phone:513-232-7100
Mailing Address - Fax:513-232-6975
Practice Address - Street 1:7575 5 MILE RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-4346
Practice Address - Country:US
Practice Address - Phone:513-232-7100
Practice Address - Fax:513-624-1240
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2022-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35070206207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0254817Medicaid
OH0254817Medicaid
OHG27047Medicare UPIN