Provider Demographics
NPI:1598096125
Name:MOKSA BATTLE, JAMEEL MIKAL (DPT, AT, DIPL OM)
Entity type:Individual
Prefix:MR
First Name:JAMEEL
Middle Name:MIKAL
Last Name:MOKSA BATTLE
Suffix:
Gender:M
Credentials:DPT, AT, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18337
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45218-0337
Mailing Address - Country:US
Mailing Address - Phone:513-349-4665
Mailing Address - Fax:513-488-0523
Practice Address - Street 1:4010 EXECUTIVE PARK DR STE 135
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-4013
Practice Address - Country:US
Practice Address - Phone:513-742-2669
Practice Address - Fax:513-488-0523
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH66.000066171100000X
2255A2300X, 374U00000X
OHPT017757225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171100000XOther Service ProvidersAcupuncturist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0005429Medicaid
OH0481352Medicaid