Basic Information
| Provider Information | |||||||||
| NPI: | 1982617601 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSE | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | BARNS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3333 BURNET AVE., ML 2001 | ||||||||
| Address2: | CHILDREN'S HOSPITAL MEDICAL CENTER | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452293039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136364408 | ||||||||
| FaxNumber: | 5136367337 | ||||||||
| Practice Location | |||||||||
| Address1: | 3333 BURNET AVE., ML 2001 | ||||||||
| Address2: | CHILDREN'S HOSPITAL MEDICAL CENTER | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136364408 | ||||||||
| FaxNumber: | 5136367337 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2006 | ||||||||
| LastUpdateDate: | 07/13/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | 35.097463 | OH | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 208000000X | 35.097463 | OH | N | Allopathic & Osteopathic Physicians | Pediatrics | 207L00000X | 35.097463 | OH | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP3000X | 35097463 | OH | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pediatric Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 0012677490 | 05 | PA | MEDICAID |