Healthcare Provider Details

I. General information

NPI: 1649237553
Provider Name (Legal Business Name): JERRY EUGENE FLEXMAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2621 DRYDEN RD. SUITE 202
DAYTON OH
45439
US

IV. Provider business mailing address

2621 DRYDEN RD THE FLEXMAN MYERS CLINIC SUITE 202
DAYTON OH
45439
US

V. Phone/Fax

Practice location:
  • Phone: 937-256-5300
  • Fax: 937-258-4162
Mailing address:
  • Phone: 937-256-5300
  • Fax: 937-258-4162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number2375
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: