Provider Demographics
NPI:1063696219
Name:DEBORAH R PILLOW MD INC
Entity type:Organization
Organization Name:DEBORAH R PILLOW MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:PILLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-941-8300
Mailing Address - Street 1:16 EAST MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ADDYSTON
Mailing Address - State:OH
Mailing Address - Zip Code:45001-0489
Mailing Address - Country:US
Mailing Address - Phone:513-941-8300
Mailing Address - Fax:513-941-8340
Practice Address - Street 1:16 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:ADDYSTON
Practice Address - State:OH
Practice Address - Zip Code:45001-0489
Practice Address - Country:US
Practice Address - Phone:513-941-8300
Practice Address - Fax:513-941-8340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 057335207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00132994OtherRAILROAD MEDICARE
OHDE9328862Medicare PIN