Individual
DR. JORGE TAN GO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2925 VERNON PL STE 100, CINCINNATI, OH 45219-2425
(513) 751-6667
(513) 872-4553
Mailing address
2925 VERNON PL STE 100, CINCINNATI, OH 45219-2425
(513) 751-6667
(513) 872-4553
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
37291
IA
207RG0100X
Gastroenterology Physician
Primary
35132137
OH
207RG0100X
Gastroenterology Physician
37291
IA
208M00000X
Hospitalist Physician
37291
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70633
WELLMARK BLUE SHIELD
IA
01
—
71305
WELLMARK BCBS
IA
01
—
71701
WELLMARK BLUE SHIELD
IA
01
—
P00433925
RAILROAD MEDICARE
IA
Enumeration date
06/29/2007
Last updated
04/17/2024
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