Provider Demographics
NPI:1053412023
Name:PEEDEN, KATHRYN MARGARET (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:MARGARET
Last Name:PEEDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8000 5 MILE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2163
Mailing Address - Country:US
Mailing Address - Phone:513-624-1216
Mailing Address - Fax:513-231-0811
Practice Address - Street 1:8000 5 MILE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2163
Practice Address - Country:US
Practice Address - Phone:513-624-1216
Practice Address - Fax:513-231-0811
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35084896207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2512874Medicaid
OHI15812Medicare UPIN
OH2512874Medicaid