Provider Demographics
NPI:1891006607
Name:ROEBEL, JOHN LAWRENCE (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:LAWRENCE
Last Name:ROEBEL
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 1:3333 BURNET AVE
Mailing Address - Street 2:MLC 5031
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4504
Mailing Address - Fax:513-636-8145
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:MLC 5031
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4504
Practice Address - Fax:513-636-8145
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35. 1264022085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology