Basic Information
| Provider Information | |||||||||
| NPI: | 1245387265 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OHIO VALLEY ORTHOPAEDICS AND SPORTS MEDICINE, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8311 MONTGOMERY RD | ||||||||
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| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452362227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139853700 | ||||||||
| FaxNumber: | 5139853706 | ||||||||
| Practice Location | |||||||||
| Address1: | 3050 MACK RD | ||||||||
| Address2: | SUITE 330 | ||||||||
| City: | FAIRFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450145379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139853700 | ||||||||
| FaxNumber: | 5139853706 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2007 | ||||||||
| LastUpdateDate: | 11/19/2009 | ||||||||
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| AuthorizedOfficialLastName: | MACKEY | ||||||||
| AuthorizedOfficialFirstName: | CAROL ANN | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5139853700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.