Basic Information
| Provider Information | |||||||||
| NPI: | 1548263866 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JABIN | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | KATHRYN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2060 READING RD | ||||||||
| Address2: | STE 150 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452021454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137213200 | ||||||||
| FaxNumber: | 5136393186 | ||||||||
| Practice Location | |||||||||
| Address1: | 9312 WINTON RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452313978 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139220009 | ||||||||
| FaxNumber: | 5139312481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2005 | ||||||||
| LastUpdateDate: | 07/31/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 35.064152 | OH | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 000000038637 | 01 | OH | ANTHEM | OTHER | 311575051052 | 01 | OH | CARESOURCE | OTHER | 160046327 | 01 | OH | MEDCIARE RAILROAD | OTHER | 288003 | 01 | OH | AMERIGROUP | OTHER | 2135551 | 01 | OH | AETNA | OTHER | 0162649 | 05 | OH | MEDICAID | 0701225 | 01 | OH | UNITED HEALTHCARE | OTHER |