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General NPI Number Information
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NPI Number | 1760608764
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Entity Type | Organization
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Legal Business Name | DRS GREEN AND HODGE INC
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1176 E HOME RD
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City | SPRINGFIELD
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State | OH
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Zip | 45503
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Country | US
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Telephone | 937-222-2096
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Fax | 937-222-2946
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Provider Business Mailing Address
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Address Line | 300 FOREST AVE
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City | DAYTON
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State | OH
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Zip | 45405-4500
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Country | US
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Telephone | 937-222-2096
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Fax | 937-222-2946
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. DARIO L GREEN
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Credential | DO
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Telephone | 937-222-2096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 34005569
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License Number State | OH
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