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General NPI Number Information
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NPI Number | 1235274341
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Entity Type | Organization
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Legal Business Name | HEALTH SPECIALISTS OF DAYTON INC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 105 SUGAR CAMP CIR
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City | DAYTON
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State | OH
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Zip | 45409-1962
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Country | US
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Telephone | 937-222-3937
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Fax | 937-223-5416
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Provider Business Mailing Address
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Address Line | 105 SUGAR CAMP CIR
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City | DAYTON
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State | OH
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Zip | 45409-1962
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Country | US
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Telephone | 937-222-3937
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Fax | 937-223-5416
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | KENNETH J PRUNIER
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Credential |
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Telephone | 937-208-8252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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