Healthcare Provider Details

I. General information

NPI: 1225598980
Provider Name (Legal Business Name): ANDREW JONATHAN CAREY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WYOMING ST
DAYTON OH
45409-2722
US

IV. Provider business mailing address

6900 EMORY PL
DAYTON OH
45424-1856
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-3882
  • Fax:
Mailing address:
  • Phone: 423-414-2917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number35.140074
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number37326
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number35.140074
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: