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NPI Code Detail

MEDICARE: ORTHOPEDIC ASOC OF SW OHIO, INC.

MEDICARE: ORTHOPEDIC ASOC OF SW OHIO, 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
1207X00000XOrthopaedic Surgery Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CF6697OTHEROHRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952303331
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORTHOPEDIC ASOC OF SW OHIO, INC.
Provider Business Mailing Address
First Line : 4160 LITTLE YORK RD
Second Line : STE 10
City : DAYTON
State : OH
Zip : 45414-5803
Country : US
Telephone Number : 937-415-9100
Fax Number : 937-415-9191
Provider Business Practice Location Address
First Line : 4160 LITTLE YORK RD
Second Line : STE 10
City : DAYTON
State : OH
Zip : 45414-5803
Country : US
Telephone Number : 937-415-9100
Fax Number : 937-415-9191
Authorized Official
Title or Position : CREDENTIALING SPECIALIST
Name : CRYSTAL A LOCKARD
Credential :
Telephone Number : 937-415-9100
Provider Enumeration Date : 08/15/2005
Last Update Date : 09/11/2008

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