Provider Demographics
NPI:1952452500
Name:ASSOCIATES OF ANDERSON OB/GYN, INC
Entity Type:Organization
Organization Name:ASSOCIATES OF ANDERSON OB/GYN, INC
Other - Org Name:HEALTHSOURCE: ANDERSON OB/GYN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:DILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-474-2870
Mailing Address - Street 1:8074 BEECHMONT AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255
Mailing Address - Country:US
Mailing Address - Phone:513-474-2870
Mailing Address - Fax:513-688-8584
Practice Address - Street 1:8074 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-5108
Practice Address - Country:US
Practice Address - Phone:513-474-2870
Practice Address - Fax:513-688-8584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2103155Medicaid
OH9276951Medicare PIN