Carl Jack Fichtenbaum
Internist Pediatrician Infectious Disease
200 Albert Sabin Way # 405
Cincinnati
, Ohio 45267-2800
Carl Jack Fichtenbaum
Internist Pediatrician Infectious Disease
200 Albert Sabin Way # 405
Cincinnati
, Ohio 45267-2800
(513) 245-3449
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About
Features
Specialties
- Internist
- Infectious Disease
- Pediatrician
Languages spoken
- English
Location
First Address
- Carl Jack Fichtenbaum
- 2830 Victory Pkwy Ste 310
- Cincinnati, OH
- Zip : 45206-3700
- Fax : (513) 245-3449
- Phone : (513) 245-3444
Second Address
- Carl Jack Fichtenbaum
- 200 Albert Sabin Way # 405
- Cincinnati, OH
- Zip : 45267-2800
- Fax : (513) 584-6040
- Phone : (513) 584-6977
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207R00000X | Internist | 35-076757 | OH |
| N | 111NI0900X | Internist | 35-076757 | OH |
| Y | 207RI0200X | Infectious Disease | 35-076757 | OH |
| N | 208000000X | Pediatrician | 35-076757 | OH |
National Provider Identifier
| NPI | 1073578951 |
|---|---|
| Provider Name | Carl Jack Fichtenbaum |
| First Address | Cincinnati, OH 45206-3700 |
| Second Address | Cincinnati, OH 45267-2800 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/04/2006 |
| Last Update Date | 27/03/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 010064796 | RAIL ROAD MEDICARE (01) | OH |
| 200252570 | (05) | IN |
| 2147484 | (05) | OH |
| 64005580 | (05) | KY |
| E80503 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.