Healthcare Provider Details

I. General information

NPI: 1689183683
Provider Name (Legal Business Name): ORTHOPEDIC ASSOCIATES OF S W OHIO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2017
Last Update Date: 01/09/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N B STREET STE 110
HAMILTON OH
45013
US

IV. Provider business mailing address

6551 CENTERVILLE BUSINESS PKWY STE 120
CENTERVILLE OH
45459-2696
US

V. Phone/Fax

Practice location:
  • Phone: 800-824-9861
  • Fax:
Mailing address:
  • Phone: 937-415-9100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ANGELA LAYMAN
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 937-415-9137