Individual
JASON ROSS MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3301 MERCY BOULEVARD, SUITE 340, CINCINNATI, OH 45211-1112
(513) 981-5922
(513) 385-6430
Mailing address
3301 MERCY BOULEVARD, SUITE 340, CINCINNATI, OH 45211-1112
(513) 981-5922
(513) 385-6430
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35085748
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2552090
—
OH
Enumeration date
07/01/2005
Last updated
12/06/2013
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