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NPI Code Detail

MEDICARE: DAYTON OPTOMETRIC CENTER INC.

MEDICARE: DAYTON OPTOMETRIC CENTER INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194722603
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAYTON OPTOMETRIC CENTER INC.
Provider Business Mailing Address
First Line : 813 TROY ST.
Second Line :
City : DAYTON
State : OH
Zip : 45404-1852
Country : US
Telephone Number : 937-228-2020
Fax Number : 937-228-8769
Provider Business Practice Location Address
First Line : 813 TROY ST.
Second Line :
City : DAYTON
State : OH
Zip : 45404-1852
Country : US
Telephone Number : 937-228-2020
Fax Number : 937-228-8769
Authorized Official
Title or Position : PRESIDENT, D.O.C. JNC
Name : DR. RONALD MYRON GILBERT
Credential : OD
Telephone Number : 937-228-2020
Provider Enumeration Date : 06/30/2005
Last Update Date : 07/21/2022

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1306026968 — MS. YOLANDA RANE ROPER RN BSN 344547
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Directions to “DAYTON OPTOMETRIC CENTER INC. ” Practice Location

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