Provider Demographics
NPI:1073787537
Name:DILEY MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:DILEY MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:WHITT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:614-949-1377
Mailing Address - Street 1:475 HILL RD N
Mailing Address - Street 2:SUITE C
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-1157
Mailing Address - Country:US
Mailing Address - Phone:614-949-1377
Mailing Address - Fax:614-863-6164
Practice Address - Street 1:475 HILL RD N
Practice Address - Street 2:SUITE C
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-1157
Practice Address - Country:US
Practice Address - Phone:614-949-1377
Practice Address - Fax:614-863-6164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL34-00-7003W207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty