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NPI Code Detail

MEDICARE: DAYTON ORTHOPAEDIC SURGERY & SPORTS MEDICINE CENTER

MEDICARE: DAYTON ORTHOPAEDIC SURGERY & SPORTS MEDICINE CENTER
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
1207XX0005XSports Medicine (Orthopaedic Surgery) Physician55720OH

General Provider Information

NPI Number : 1851423545
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAYTON ORTHOPAEDIC SURGERY & SPORTS MEDICINE CENTER
Provider Business Mailing Address
First Line : 5491 FAR HILLS AVE
Second Line :
City : DAYTON
State : OH
Zip : 45429-2325
Country : US
Telephone Number : 937-436-5763
Fax Number : 937-436-7399
Provider Business Practice Location Address
First Line : 5491 FAR HILLS AVE
Second Line :
City : DAYTON
State : OH
Zip : 45429-2325
Country : US
Telephone Number : 937-436-5763
Fax Number : 937-436-7399
Authorized Official
Title or Position : OFFICE MANAGER
Name : MELISSA HOBBS
Credential :
Telephone Number : 937-436-5763
Provider Enumeration Date : 03/09/2007
Last Update Date : 08/22/2020

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Directions to “DAYTON ORTHOPAEDIC SURGERY & SPORTS MEDICINE CENTER ” Practice Location

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