Provider Demographics
NPI:1891181772
Name:BEDARD-THOMAS, JULIA CAMILLE (MD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:CAMILLE
Last Name:BEDARD-THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:CAMILLE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3805 EDWARDS RD STE 350
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1940
Mailing Address - Country:US
Mailing Address - Phone:513-871-7848
Mailing Address - Fax:513-871-3278
Practice Address - Street 1:3805 EDWARDS RD STE 350
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-1940
Practice Address - Country:US
Practice Address - Phone:513-871-7848
Practice Address - Fax:513-871-3278
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-1330122084P0800X
OH35.133012207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0448406Medicaid