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Organization

BEACON ORTHOPAEDICS & SPORTS MEDICINE

Active
Other names
Beacon East
Organization subpart
No

Provider details

NPI number
Authorized official
SANDRA S DAVENPORT (CREDENTIALING SPECIALIST)
(513) 354-7650
Entity
Organization

Contact information

Practice address
463 OHIO PIKE, SUITE 201, CINCINNATI, OH 45255-3721
(513) 354-3700
(513) 354-7651
Mailing address
6480 HARRISON AVE, SUITE 201, CINCINNATI, OH 45247-7961
(513) 354-7650
(513) 354-7651

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Enumeration date
07/14/2011
Last updated
07/14/2011
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