Organization
MAYFIELD CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J RADOMSKI VP (VICE PRESIDENT)
(513) 221-1100
Entity
Organization
Contact information
Practice address
3825 EDWARDS RD STE 300, CINCINNATI, OH 45209-1288
(513) 221-1100
(513) 569-5279
Mailing address
PO BOX 643398, CINCINNATI, OH 45264-3398
(513) 221-1100
(513) 569-5279
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207T00000X
Neurological Surgery Physician
Primary
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081P0004X
Spinal Cord Injury Medicine Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
225100000X
Physical Therapist
—
—
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0358723
—
OH
05
—
100001460A
—
IN
05
—
65903387
—
KY
05
—
7100011860
—
KY
05
—
7100347010
—
KY
05
—
7100357630
—
KY
01
—
CC0892
RAILROAD MEDICARE
OH
01
—
CF9178
RAILROAD MEDICARE
KY
Enumeration date
07/11/2006
Last updated
07/10/2024
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