Healthcare Provider Details

I. General information

NPI: 1033727292
Provider Name (Legal Business Name): DAYTON CARDIOLOGY CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2020
Last Update Date: 10/31/2020
Certification Date: 10/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6635 CENTERVILLE BUSINESS PKWY
CENTERVILLE OH
45459-2655
US

IV. Provider business mailing address

6635 CENTERVILLE BUSINESS PKWY
CENTERVILLE OH
45459-2655
US

V. Phone/Fax

Practice location:
  • Phone: 937-951-2016
  • Fax: 937-951-2018
Mailing address:
  • Phone: 937-951-2016
  • Fax: 937-951-2018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. CATHY A CORBEIL
Title or Position: OFFICE MANAGER
Credential:
Phone: 937-951-2016