Individual
JON RAYMOND MINZNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2765 CHAPEL PL, SUITE 200, CRESTVIEW HILLS, KY 41017-3413
(859) 578-3400
(859) 957-0055
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 578-3400
(859) 957-0055
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35639
KY
208000000X
Pediatrics Physician
35639
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2387975
—
OH
05
—
64012800
—
KY
01
—
P00327046
RAILROAD MEDICARE
KY
Enumeration date
03/29/2006
Last updated
09/10/2018
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