Provider Demographics
NPI:1841281987
Name:CURRY, TRACE WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:TRACE
Middle Name:WILLIAM
Last Name:CURRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10475 READING ROAD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241
Mailing Address - Country:US
Mailing Address - Phone:513-559-1222
Mailing Address - Fax:513-559-1235
Practice Address - Street 1:10475 READING RD
Practice Address - Street 2:SUITE 117
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2563
Practice Address - Country:US
Practice Address - Phone:513-559-1222
Practice Address - Fax:513-559-1235
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074062208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2060979Medicaid
G78361Medicare UPIN
OH2060979Medicaid