Provider Demographics
NPI:1770543969
Name:ANNESS, STUART H (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:H
Last Name:ANNESS
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 1:1945 CEI DRIVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242
Mailing Address - Country:US
Mailing Address - Phone:513-569-3741
Mailing Address - Fax:513-569-3941
Practice Address - Street 1:3267 WESTBOURNE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-5130
Practice Address - Country:US
Practice Address - Phone:513-662-2280
Practice Address - Fax:513-662-4730
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-3787207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64027915Medicaid
IN200200800Medicaid
OH000000021168OtherANTHEM
OH180035422OtherRAILROAD MEDICARE
OH0546305Medicaid
KY64027915Medicaid
OH0512035Medicare PIN
IN200200800Medicaid