Basil, Jack B

Basil, Jack B is an individual health care provider with primary practice located at 3219 Clifton Ave Suite 100, Cincinnati OH 45220-3027. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecologic Oncology, which is considered as his primary health care specialty. Basil, Jack B can be contacted via phone (513) 862-1888.

Contact Information

Primary practice address
3219 Clifton Ave Suite 100 Cincinnati OH 45220-3027
Phone: (513) 862-1888
Fax: (513) 862-3616
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecologic Oncology 207VX0201X 35084002 Ohio

Profile Details

NPI number 1073505525
LBN Legal business name Basil, Jack B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Sep 17th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073505525 NPPES
Kentucky MEDICAID 64083140
Kentucky MEDICAID 200215750
Kentucky MEDICAID 2473256

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