MEDICARE: DAYTON PHYSICIANS, LLC

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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	208800000X	Urology Physician	021911103	OH

General Provider Information

NPI Number	:	1265824874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAYTON PHYSICIANS, LLC

Provider Business Mailing Address
First Line	:	6680 POE AVE
Second Line	:	SUITE 200
City	:	DAYTON
State	:	OH
Zip	:	45414-2854
Country	:	US
Telephone Number	:	937-280-8400
Fax Number	:	937-280-8373

Provider Business Practice Location Address
First Line	:	2350 MIAMI VALLEY DR
Second Line	:	SUITE 500
City	:	CENTERVILLE
State	:	OH
Zip	:	45459-4778
Country	:	US
Telephone Number	:	937-425-0003
Fax Number	:	937-280-8373

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	AMY C PANSTINGEL
Credential	:	CMRS
Telephone Number	:	937-280-8366

Provider Enumeration Date	:	02/19/2015
Last Update Date	:	03/09/2026

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Directions to “DAYTON PHYSICIANS, LLC ” Practice Location

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