Provider Demographics
NPI:1285883694
Name:ELIZABETH COTTINGHAM, M.D. LLC
Entity type:Organization
Organization Name:ELIZABETH COTTINGHAM, M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:COTTINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-721-1737
Mailing Address - Street 1:58 E HOLLISTER ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-1704
Mailing Address - Country:US
Mailing Address - Phone:513-721-1737
Mailing Address - Fax:513-287-7465
Practice Address - Street 1:58 E HOLLISTER ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-1704
Practice Address - Country:US
Practice Address - Phone:513-721-1737
Practice Address - Fax:513-287-7465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH72493174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F44581Medicare UPIN