Basic Information
| Provider Information | |||||||||
| NPI: | 1497716005 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASSOCIATES IN OB GYN, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 440 RAY NORRISH DR | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452461520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136717700 | ||||||||
| FaxNumber: | 5136717705 | ||||||||
| Practice Location | |||||||||
| Address1: | 440 RAY NORRISH DR | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452461520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136717700 | ||||||||
| FaxNumber: | 5136717705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2006 | ||||||||
| LastUpdateDate: | 10/30/2007 | ||||||||
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| AuthorizedOfficialLastName: | FRIEDRICH | ||||||||
| AuthorizedOfficialFirstName: | SANDIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 5136717700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 2472097 | 05 | OH | MEDICAID |