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General NPI Number Information
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NPI Number | 1700397825
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Entity Type | Individual
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Provider Name | BRYN THATCHER MD
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Gender | Female
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Dates
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Enumeration Date | 10/16/2017
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 1 WYOMING ST
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City | DAYTON
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State | OH
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Zip | 45409-2722
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Country | US
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Telephone | 937-208-3882
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Fax |
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Provider Business Mailing Address
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Address Line | 1 WYOMING ST. ATTN: PAM SHANK
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City | DAYTON
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State | OH
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Zip | 45409
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Country | US
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Telephone | 937-208-3882
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Fax |
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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 | 11022510A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.1300114
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 57.259516
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 57.259516
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License Number State | OH
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