Healthcare Provider Details

I. General information

NPI: 1659772887
Provider Name (Legal Business Name): ALLIANCE PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2014
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 WASHNGTON VLG DR SUITE 200
CENTERVILLE OH
45459-4094
US

IV. Provider business mailing address

1 PRESTIGE PL SUITE 550
MIAMISBURG OH
45342-3794
US

V. Phone/Fax

Practice location:
  • Phone: 937-436-9825
  • Fax: 937-433-6508
Mailing address:
  • Phone: 937-762-1305
  • Fax: 937-522-7513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY Y KO
Title or Position: CHIEF FINANCIAL OFFICER (CFO)
Credential:
Phone: 937-558-3208