MEDICARE: DAYTON MEDICAL ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	7864	NV

General Provider Information

NPI Number	:	1093839391
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAYTON MEDICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	PO BOX 21530
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89721-1530
Country	:	US
Telephone Number	:	775-884-2455
Fax Number	:	775-884-0345

Provider Business Practice Location Address
First Line	:	5 PINE CONE RD
Second Line	:	SUITE 102
City	:	DAYTON
State	:	NV
Zip	:	89403-7393
Country	:	US
Telephone Number	:	775-246-0200
Fax Number	:	775-246-0812

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT J KIMMEL
Credential	:	M.D.
Telephone Number	:	775-246-0200

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	10/04/2007

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Directions to “DAYTON MEDICAL ASSOCIATES ” Practice Location

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