Provider Demographics
NPI:1902827306
Name:KAZIOR, RICHARD JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOHN
Last Name:KAZIOR
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 1:10496 MONTGOMERY RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5223
Mailing Address - Country:US
Mailing Address - Phone:513-891-9990
Mailing Address - Fax:
Practice Address - Street 1:10496 MONTGOMERY RD
Practice Address - Street 2:SUITE 212
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-5223
Practice Address - Country:US
Practice Address - Phone:513-891-9990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35052062207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0598590Medicaid
OHKA0572321Medicare ID - Type UnspecifiedPROVIDER NUMBER
OH0598590Medicaid