=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740785898
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL JOSEPH GAWRON MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2018
-----------------------------------------------------
Last Update Date | 01/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4777 E GALBRAITH RD
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45236-2725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-558-5281
-----------------------------------------------------
Fax | 513-558-5791
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 231 ALBERT SABIN WAY, MSB 1654, ML 0769 UC EMERGENCY MEDICINE
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45267-0769
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-558-5281
-----------------------------------------------------
Fax | 513-558-5791
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | 35.141763
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207PS0010X
-----------------------------------------------------
Taxonomy Name | Sports Medicine (Emergency Medicine) Physician
-----------------------------------------------------
License Number | 35141763
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------