Divine, Jon G
Divine, Jon G is an individual health care provider with primary practice located at 222 Piedmont Ave Ml 0212, Cincinnati OH 45219-4231. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Divine, Jon G can be contacted via phone (513) 475-8690.Contact Information
Primary practice address
222 Piedmont Ave Ml 0212
Cincinnati OH 45219-4231
Phone: (513) 475-8690
Fax: (513) 475-7593
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 35-070497 | Ohio |
Profile Details
| NPI number | 1659391761 |
|---|---|
| LBN Legal business name | Divine, Jon G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2006 |
| Last updated | Oct 17th, 2013 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659391761 | NPPES |
| Kentucky | MEDICAID | 64077175 | |
| Kentucky | MEDICAID | 2475503 |
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