Healthcare Provider Details

I. General information

NPI: 1679548739
Provider Name (Legal Business Name): DAYTON OSTEOPATHIC HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 STANLEY AVE
DAYTON OH
45404-1201
US

IV. Provider business mailing address

2351 STANLEY AVE
DAYTON OH
45404-1201
US

V. Phone/Fax

Practice location:
  • Phone: 937-228-0990
  • Fax: 937-228-6090
Mailing address:
  • Phone: 937-228-0990
  • Fax: 937-228-6090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANIEL D HAIBACH
Title or Position: DIRECTOR
Credential:
Phone: 937-384-4836