Basic Information
| Provider Information | |||||||||
| NPI: | 1710117635 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLERGY & ASTHMA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7927 JESSIES WAY | ||||||||
| Address2: | |||||||||
| City: | HAMILTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450118077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138940500 | ||||||||
| FaxNumber: | 5138940500 | ||||||||
| Practice Location | |||||||||
| Address1: | 7927 JESSIES WAY | ||||||||
| Address2: | |||||||||
| City: | HAMILTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450118077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138940500 | ||||||||
| FaxNumber: | 5138940500 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2009 | ||||||||
| LastUpdateDate: | 09/25/2015 | ||||||||
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| AuthorizedOfficialLastName: | LEIPZIG | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 5138940500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207KA0200X | 35074376L | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Allergy & Immunology | Allergy |
No ID Information.