Basic Information
Provider Information | |||||||||
NPI: | 1427137470 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | KUMAR | ||||||||
FirstName: | RADHIKA | ||||||||
MiddleName: | LINGAM | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | CHANDOKE | ||||||||
OtherFirstName: | RADHIKA | ||||||||
OtherMiddleName: | LINGAM | ||||||||
OtherNamePrefix: | DR. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | M.D. | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 5535 FAIR LN | ||||||||
Address2: | SUITE C | ||||||||
City: | CINCINNATI | ||||||||
State: | OH | ||||||||
PostalCode: | 452273434 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5132215274 | ||||||||
FaxNumber: | 5139615100 | ||||||||
Practice Location | |||||||||
Address1: | 7850 CAMARGO RD | ||||||||
Address2: |   | ||||||||
City: | CINCINNATI | ||||||||
State: | OH | ||||||||
PostalCode: | 452432652 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5135615655 | ||||||||
FaxNumber: | 5135612319 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/02/2006 | ||||||||
LastUpdateDate: | 07/30/2015 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 35.098252 | OH | Y |   | Allopathic & Osteopathic Physicians | Ophthalmology |   |
ID Information
ID | Type | State | Issuer | Description | 35.098252 | 01 | OH | OHIO MEDICA LICENSE NUMBER | OTHER | 650919 | 01 | OH | WELLCARE | OTHER | P01027902 | 01 | OH | RAILROAD MEDICARE | OTHER | 4249381 | 01 | OH | CIGNA | OTHER |