Individual
DR. IAN M PAQUETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2123 AUBURN AVE, CINCINNATI, OH 45219-2906
(513) 929-0104
(513) 929-4369
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5506
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
13264
NH
208600000X
Surgery Physician
35.097012
OH
208C00000X
Colon & Rectal Surgery Physician
Primary
35.097012
OH
208C00000X
Colon & Rectal Surgery Physician
53132
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201020980
—
IN
05
—
3141808
—
OH
05
—
7100160520
—
KY
Enumeration date
10/20/2006
Last updated
02/22/2018
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