MEDICARE: FIRST DAYTON RADIATION ONCOLOGY 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
1	2085R0202X	Diagnostic Radiology Physician	35067354H	OH
2	2085R0001X	Radiation Oncology Physician	35067354H	OH

General Provider Information

NPI Number	:	1487641585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST DAYTON RADIATION ONCOLOGY INC

Provider Business Mailing Address
First Line	:	2632 WOODMAN CENTER CT
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45420-1477
Country	:	US
Telephone Number	:	937-293-2273
Fax Number	:	937-293-6573

Provider Business Practice Location Address
First Line	:	2632 WOODMAN CENTER CT
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45420-1477
Country	:	US
Telephone Number	:	937-293-2273
Fax Number	:	937-293-6573

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EDWARD N HUGHES JR.
Credential	:	MD
Telephone Number	:	937-293-2273

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	03/27/2014

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