Provider Demographics
NPI:1174560833
Name:THE ENT GROUP INC
Entity type:Organization
Organization Name:THE ENT GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-632-5264
Mailing Address - Street 1:2123 AUBURN AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:513-632-5801
Mailing Address - Fax:513-632-5802
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-421-5558
Practice Address - Fax:513-632-5804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2609234Medicaid
OH00000018636OtherANTHEM
OH0218080Medicaid
OH2609234Medicaid