Basic Information
| Provider Information | |||||||||
| NPI: | 1619004348 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OHIO VALLEY ORTHOPAEDICS AND SPORTS MEDICINE, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8044 MONTGOMERY RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452362919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139853700 | ||||||||
| FaxNumber: | 5139853706 | ||||||||
| Practice Location | |||||||||
| Address1: | 8044 MONTGOMERY RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452362919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139853700 | ||||||||
| FaxNumber: | 5139853706 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2007 | ||||||||
| LastUpdateDate: | 07/26/2007 | ||||||||
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| AuthorizedOfficialLastName: | SCHMIDT | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 5139853700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | 0317170001 | 01 | OH | DMERC GROUP NUMBER | OTHER |