Basic Information
Provider Information
NPI: 1285830141
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOWBIN
FirstName: ALEXANDER
MiddleName: JUSTIN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3333 BURNET AVENUE
Address2: ML 5031
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber: 5136364251
FaxNumber: 5136368145
Practice Location
Address1: 3333 BURNET AVE
Address2: ML 5031
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber: 5136364251
FaxNumber: 5136368145
Other Information
ProviderEnumerationDate: 06/26/2007
LastUpdateDate: 11/24/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085P0229X35.089893OHY Allopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
2085R0202X35 089893OHN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


Home