Individual
REBECCA S CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
350 THOMAS MORE PKWY, SUITE 160, CRESTVIEW HILLS, KY 41017-5465
(513) 221-1100
(513) 569-5297
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 245-3107
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
35.059824
OH
2085R0202X
Diagnostic Radiology Physician
Primary
35381
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000014204
ANTHEM
OH
05
—
0786645
—
OH
01
—
138300001
CARESOURCE
OH
01
—
1620959
UNITED HEALTHCARE
OH
05
—
200039490A
—
IN
01
—
300033820
RAILROAD MEDICARE
OH
05
—
64864200
—
KY
01
—
655253
AETNA
OH
Enumeration date
01/19/2006
Last updated
02/19/2018
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