Provider Demographics
NPI:1538192331
Name:ORTHOPAEDIC INSTITUTE OF DAYTON INC
Entity type:Organization
Organization Name:ORTHOPAEDIC INSTITUTE OF DAYTON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-531-6688
Mailing Address - Street 1:3205 WOODMAN DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-1143
Mailing Address - Country:US
Mailing Address - Phone:937-298-4417
Mailing Address - Fax:937-298-8260
Practice Address - Street 1:3205 WOODMAN DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45420-1143
Practice Address - Country:US
Practice Address - Phone:937-298-4417
Practice Address - Fax:937-298-8260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0182921Medicaid
OH0182921Medicaid
OH0281490001Medicare NSC