Healthcare Provider Details

I. General information

NPI: 1366366999
Provider Name (Legal Business Name): RYAN PYLES-DODDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 SOUTHERN BLVD
KETTERING OH
45429-1221
US

IV. Provider business mailing address

210 W WALNUT ST
TIPP CITY OH
45371-1852
US

V. Phone/Fax

Practice location:
  • Phone: 937-701-9841
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number153607
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: