Provider Demographics
NPI:1104954874
Name:GENERATIONS OBSTETRICS & GYNECOLOGY
Entity type:Organization
Organization Name:GENERATIONS OBSTETRICS & GYNECOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:937-748-3069
Mailing Address - Street 1:5 SYCAMORE CREEK DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-2300
Mailing Address - Country:US
Mailing Address - Phone:937-748-3069
Mailing Address - Fax:937-748-3576
Practice Address - Street 1:5 SYCAMORE CREEK DR
Practice Address - Street 2:SUITE B
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-2300
Practice Address - Country:US
Practice Address - Phone:937-748-3069
Practice Address - Fax:937-748-3576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHG96135Medicare UPIN