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NPI 1306849823

NPI 1306849823 : RICK W GEBHART D.O. : VANDALIA, OH

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General NPI Number Information
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    NPI Number           |    1306849823
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    Entity Type          |    Individual 
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    Provider Name        |    RICK W GEBHART D.O.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/30/2005
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    Last Update Date     |    01/24/2019
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Provider Practice Location Address
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    Address Line         |    505 CORPORATE CENTER DR 
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    City                 |    VANDALIA
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    State                |    OH
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    Zip                  |    45377-1167
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    Country              |    US
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    Telephone            |    937-619-0050
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    Fax                  |    937-619-0069
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Provider Business Mailing Address
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    Address Line         |    1 PRESTIGE PL STE 550 
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    City                 |    MIAMISBURG
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    State                |    OH
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    Zip                  |    45342-6115
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    Country              |    US
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    Telephone            |    937-619-0050
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    Fax                  |    937-619-0069
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    34005782
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    License Number State |    OH
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