Provider Demographics
NPI:1962546416
Name:CINCINNATI MEDICAL CONSULTANTS, INC.
Entity type:Organization
Organization Name:CINCINNATI MEDICAL CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:O
Authorized Official - Last Name:DILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-751-2221
Mailing Address - Street 1:791 E MCMILLAN ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1943
Mailing Address - Country:US
Mailing Address - Phone:513-751-2221
Mailing Address - Fax:513-751-8805
Practice Address - Street 1:791 E MCMILLAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1943
Practice Address - Country:US
Practice Address - Phone:513-751-2221
Practice Address - Fax:513-751-8805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-029778207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2661972Medicaid
OHCI9355551Medicare PIN
OHCOO776Medicare UPIN