Organization
WEST SIDE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANIE TEBBEN (PRACTICE MANAGER)
(513) 347-5083
Entity
Organization
Contact information
Practice address
7074 HARRISON AVE, CINCINNATI, OH 45247
(513) 922-8200
(513) 347-0082
Mailing address
663 ANDERSON FERRY RD, CINCINNATI, OH 45238
(513) 922-8200
(513) 347-0082
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0954794
—
OH
Enumeration date
06/20/2017
Last updated
06/20/2017
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