Provider Demographics
NPI:1396746301
Name:BRICKING, TODD R (MD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:R
Last Name:BRICKING
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 1:4415 AICHOLTZ RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1506
Mailing Address - Country:US
Mailing Address - Phone:513-752-9610
Mailing Address - Fax:513-732-8734
Practice Address - Street 1:1701 MERCY HEALTH PL
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-6147
Practice Address - Country:US
Practice Address - Phone:513-952-5930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37143207P00000X
OH35070974207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64942956Medicaid
OH2034908Medicaid
OH2034908Medicaid
OHH076371Medicare PIN
G61137Medicare UPIN