Individual
DR. JOHN HERGENROTHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2123 AUBURN AVE, #404, CINCINNATI, OH 45219-2906
(513) 241-5630
(513) 241-7146
Mailing address
2123 AUBURN AVE, #404, CINCINNATI, OH 45219-2906
(513) 241-5630
(513) 241-7146
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
35-07-5061
OH
207RN0300X
Nephrology Physician
37649
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2330203
—
OH
01
—
390008623
MEDICARE RAILROAD
OH
05
—
64054018
—
KY
Enumeration date
06/15/2006
Last updated
11/02/2011
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