Healthcare Provider Details

I. General information

NPI: 1215057591
Provider Name (Legal Business Name): FIRST DAYTON ORTHOPEDISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 02/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 MIAMISBURG CENTERVILLE RD STE. 110
MIAMISBURG OH
45342-3674
US

IV. Provider business mailing address

4000 MIAMISBURG CENTERVILLE RD STE. 110
MIAMISBURG OH
45342-3674
US

V. Phone/Fax

Practice location:
  • Phone: 937-865-9000
  • Fax: 937-865-9002
Mailing address:
  • Phone: 937-865-9000
  • Fax: 937-865-9002

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: TARA L MEYERS
Title or Position: BOOKKEEPER
Credential:
Phone: 937-865-9000