Individual
DR. WALTER G BROADNAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5505 FAIR LN, CINCINNATI, OH 45227-3401
(513) 421-7246
(513) 421-7796
Mailing address
1220 PADDOCK HILLS AVE, CINCINNATI, OH 45229-1218
(513) 421-7246
(513) 421-7796
Taxonomy
Speciality
Code
Description
License number
State
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
Primary
35060685
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0860917
—
OH
Enumeration date
03/14/2007
Last updated
07/09/2007
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