Provider Demographics
NPI:1932213329
Name:THEURING, DOUGLAS F
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:F
Last Name:THEURING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5275 WINNESTE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45232-1130
Mailing Address - Country:US
Mailing Address - Phone:513-242-5700
Mailing Address - Fax:513-482-5461
Practice Address - Street 1:5275 WINNESTE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45232-1130
Practice Address - Country:US
Practice Address - Phone:513-242-5700
Practice Address - Fax:513-482-5461
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-08645183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
36-40352OtherNABP
OH0610128Medicaid
OH0610128Medicaid