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Individual

GEORGE R JEWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
8075 WASHINGTON VILLAGE DR STE 1, DAYTON, OH 45458-1847
(513) 241-2370
(513) 241-6053
Mailing address
4805 MONTGOMERY RD STE 150, CINCINNATI, OH 45212-2280
(513) 936-5358
(513) 961-1912

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6364
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2807654
OH
05
7100527770
KY
Enumeration date
08/09/2007
Last updated
11/14/2024
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