Healthcare Provider Details

I. General information

NPI: 1306001516
Provider Name (Legal Business Name): DAYTON CARDIOLOGY CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 09/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 MIAMI VALLEY DR
CENTERVILLE OH
45459-4774
US

IV. Provider business mailing address

1126 S MAIN ST
DAYTON OH
45409-2616
US

V. Phone/Fax

Practice location:
  • Phone: 937-223-3053
  • Fax: 937-853-0166
Mailing address:
  • Phone: 937-223-3053
  • Fax: 937-853-0166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: KATHY NAYLOR
Title or Position: SCHEDULING MGR
Credential:
Phone: 937-223-3053