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General NPI Number Information
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NPI Number | 1245342559
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Entity Type | Organization
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Legal Business Name | DAYTON PAIN MANAGEMENT LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 1074 PATTERSON ROAD
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City | DAYTON
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State | OH
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Zip | 45420-1522
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Country | US
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Telephone | 937-254-3988
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Fax | 937-254-3988
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Provider Business Mailing Address
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Address Line | 1074 PATTERSON ROAD
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City | DAYTON
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State | OH
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Zip | 45420-1522
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Country | US
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Telephone | 937-254-3988
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Fax | 937-254-3988
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Authorized Official
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Title or Position | CEO/OWNER
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Name | ROBERT E WINDSOR
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Credential | MD
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Telephone | 859-252-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 35093887
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 35093887
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | COA-13719
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 35093887
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License Number State | OH
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