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NPI Code Detail

MEDICARE: DAYTON OUTPATIENT CENTER INC

MEDICARE: DAYTON OUTPATIENT 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
1261QR0200XRadiology Clinic/Center

General Provider Information

NPI Number : 1700816717
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAYTON OUTPATIENT CENTER INC
Provider Business Mailing Address
First Line : 1010 WOODMAN DR
Second Line :
City : DAYTON
State : OH
Zip : 45432-1400
Country : US
Telephone Number : 937-424-2215
Fax Number : 937-252-1224
Provider Business Practice Location Address
First Line : 1010 WOODMAN DR
Second Line :
City : DAYTON
State : OH
Zip : 45432-1400
Country : US
Telephone Number : 937-424-2215
Fax Number : 937-252-1224
Authorized Official
Title or Position : CREDENTIALING SPECIALIST
Name : GARIMA GUPTA
Credential :
Telephone Number : 937-424-2215
Provider Enumeration Date : 07/04/2006
Last Update Date : 05/11/2023

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Directions to “DAYTON OUTPATIENT CENTER INC ” Practice Location

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