1679569842 NPI number — PHILIP D LEMING M.D.

Table of content: PHILIP D LEMING M.D. (NPI 1679569842)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679569842 NPI number — PHILIP D LEMING M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEMING
Provider First Name:
PHILIP
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679569842
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4460 RED BANK RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45227-2172
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-321-4333
Provider Business Mailing Address Fax Number:
513-232-0100

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4460 RED BANK RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45227-2172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-321-4333
Provider Business Practice Location Address Fax Number:
513-232-0100
Provider Enumeration Date:
09/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  40534 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100360560A . This is a "INDIANA MEDICAID PROVIDER" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 283805 . This is a "AMERIGROUP NUMBER" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0503002 . This is a "KENTUCKY MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 4053402 . This is a "HUMANA PROVIDER NUMBER" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 5734068 . This is a "AETNA PROVIDER ID" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000016084 . This is a "ANTHEM PROVIDER NUMBER" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0395862 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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