Provider Demographics
NPI:1942279153
Name:FLYNN, MONICA A (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:A
Last Name:FLYNN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3143 MARKBREIT AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1732
Mailing Address - Country:US
Mailing Address - Phone:513-289-5009
Mailing Address - Fax:513-871-7797
Practice Address - Street 1:3802 PAXTON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-2399
Practice Address - Country:US
Practice Address - Phone:513-289-5009
Practice Address - Fax:513-871-7797
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35064363207Q00000X, 207Q00000X
KY44494207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000307015OtherBLUE CROSS
IN200448670Medicaid
OH200448670Medicaid
IN000000307015OtherBLUE CROSS
E92396Medicare UPIN
OH200448670Medicaid