Provider Demographics
NPI:1699728972
Name:DAYTON CENTER FOR NEUROLOGICAL DISORDERS INC
Entity type:Organization
Organization Name:DAYTON CENTER FOR NEUROLOGICAL DISORDERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER/CREDENTIALLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ATCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-439-6186
Mailing Address - Street 1:1975 MIAMISBURG CENTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-3811
Mailing Address - Country:US
Mailing Address - Phone:937-439-6186
Mailing Address - Fax:937-424-3005
Practice Address - Street 1:1975 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-3811
Practice Address - Country:US
Practice Address - Phone:937-439-6186
Practice Address - Fax:937-424-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH203689OtherFEDERAL BLACK LUNG BENEFITS
OH0798810Medicaid
OH0798810Medicaid