Provider Demographics
NPI:1396986493
Name:HEALTH SPECIALISTS OF DAYTON INC
Entity type:Organization
Organization Name:HEALTH SPECIALISTS OF DAYTON INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-435-4263
Mailing Address - Street 1:200 MEDICAL CENTER DR
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-5200
Mailing Address - Country:US
Mailing Address - Phone:513-425-7110
Mailing Address - Fax:513-425-7112
Practice Address - Street 1:200 MEDICAL CENTER DR
Practice Address - Street 2:4TH FLOOR
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-5200
Practice Address - Country:US
Practice Address - Phone:513-425-7110
Practice Address - Fax:513-425-7112
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH SPECIALISTS OF DAYTON INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-19
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
9353865Medicare PIN