Basic Information
| Provider Information | |||||||||
| NPI: | 1053754838 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HADDOX | ||||||||
| FirstName: | KOREY | ||||||||
| MiddleName: | MICHAEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7502 STATE RD STE 2210A | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452552596 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136242070 | ||||||||
| FaxNumber: | 5136242077 | ||||||||
| Practice Location | |||||||||
| Address1: | 7502 STATE RD STE 2210A | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452552596 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136242070 | ||||||||
| FaxNumber: | 5136242077 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2013 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 5151013681 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 208M00000X | 34.012227 | OH | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 34.012227 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.