Healthcare Provider Details

I. General information

NPI: 1982603627
Provider Name (Legal Business Name): KEVIN JOSEPH PALEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3205 WOODMAN DR
DAYTON OH
45420-1143
US

IV. Provider business mailing address

6480 HARRISON AVE STE 201
CINCINNATI OH
45247-7961
US

V. Phone/Fax

Practice location:
  • Phone: 937-298-4417
  • Fax: 937-298-8260
Mailing address:
  • Phone: 513-713-1779
  • Fax: 513-854-9921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35068914P
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: