Individual
MR. JERROLD P TWOHIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
105 MCKNIGHT DRIVE, MIDDLETOWN, OH 45044-4898
(513) 424-2111
(513) 420-5662
Mailing address
PO BOX 640929, CINCINNATI, OH 45264-0929
(513) 727-0748
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN131849
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000015610
ANTHEM
OH
05
—
0754107
—
OH
Enumeration date
09/13/2006
Last updated
07/08/2007
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