Individual
DR. JON RICHARD FACKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11135 MONTGOMERY RD, CINCINNATI, OH 45249-2338
(513) 793-2220
(513) 793-5933
Mailing address
11135 MONTGOMERY ROAD, CINCINNATI, OH 45249
(513) 793-2220
(513) 793-5933
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
35.056413
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01272689030
—
OH
Enumeration date
06/30/2006
Last updated
07/06/2015
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