Basic Information
| Provider Information | |||||||||
| NPI: | 1407153042 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRANCIS | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | ALEXANDER | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3131 QUEEN CITY AVE | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452382316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135573333 | ||||||||
| FaxNumber: | 5135573332 | ||||||||
| Practice Location | |||||||||
| Address1: | 10250 ALLIANCE RD STE 130 | ||||||||
| Address2: | |||||||||
| City: | BLUE ASH | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452424766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2164789208 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2011 | ||||||||
| LastUpdateDate: | 07/26/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 50-003158 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 0068456 | 05 | OH | MEDICAID |