Organization
QUEEN CITY GENERAL & VASCULAR SURGEONS GROUP LTD
Active
Other names
Queen City Surgical Consultants
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PEGGY ERTEL (PRACTICE MANAGER)
(513) 232-8181
Entity
Organization
Contact information
Practice address
7502 STATE RD, STE. 1180, CINCINNATI, OH 45255-2800
(513) 232-8181
(513) 624-2964
Mailing address
1270 SOLUTIONS CENTER, PO BOX 771270, CHICAGO, IL 60677-1002
(513) 542-6898
(513) 542-7972
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200293310A
—
IN
05
—
200293310B
—
IN
05
—
200293310C
—
IN
05
—
200293310D
—
IN
05
—
200293310E
—
IN
05
—
2065867
—
OH
05
—
2066017
—
OH
05
—
2066026
—
OH
05
—
2066035
—
OH
05
—
2066044
—
OH
05
—
2066053
—
OH
05
—
2324336
—
OH
01
—
CD8400
RAILROAD MEDICARE
OH
Enumeration date
06/26/2006
Last updated
11/22/2011
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