Provider Demographics
NPI:1801900717
Name:ENGELHARDT, JOHN STUART (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:STUART
Last Name:ENGELHARDT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5981 HARRISON AVE
Mailing Address - Street 2:STE 3
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-1698
Mailing Address - Country:US
Mailing Address - Phone:513-598-1693
Mailing Address - Fax:513-598-1862
Practice Address - Street 1:5981 HARRISON AVENUE
Practice Address - Street 2:SUITE 1-3
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-1698
Practice Address - Country:US
Practice Address - Phone:513-598-1693
Practice Address - Fax:513-598-1862
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0879643Medicaid
U24054Medicare UPIN
OH0879643Medicaid