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Organization

MOORTHY MEDICAL ASSOCIATES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PALANIVEL G MOORTHY MD (OWNER)
(513) 858-6555
Entity
Organization

Contact information

Practice address
311 NILLES RD, STE G, FAIRFIELD, OH 45014-2636
(513) 858-6555
(513) 858-6222
Mailing address
PO BOX 643273, CINCINNATI, OH 45264-0307
(513) 891-2813
(513) 793-1032

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DA5393
RR MEDICARE
OH
Enumeration date
09/25/2006
Last updated
11/30/2007
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