Provider Demographics
NPI:1609852094
Name:MELSON, TODD S (DC)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:S
Last Name:MELSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4771 GLENDALE MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-3819
Mailing Address - Country:US
Mailing Address - Phone:513-793-4300
Mailing Address - Fax:513-469-1880
Practice Address - Street 1:4771 GLENDALE MILFORD RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-3819
Practice Address - Country:US
Practice Address - Phone:513-793-4300
Practice Address - Fax:513-469-1880
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1234111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000210218OtherANTHEM BCBS
1234C 03OtherCHOICE CARE
P00131057OtherRAILROAD MEDICARE
4093031Medicare ID - Type Unspecified
1234C 03OtherCHOICE CARE