Individual
JOHN GARDINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
55 PROGRESS PL, CINCINNATI, OH 45246-1715
(513) 346-5000
(513) 671-2003
Mailing address
4103 DECOURSEY AVE, COVINGTON, KY 41015-1811
(859) 261-6383
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50-00-0099
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2043868
—
OH
Enumeration date
09/16/2006
Last updated
07/08/2007
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