Provider Demographics
NPI:1093449985
Name:ORTHOPEDIC ASSOCIATES OF SW OHIO
Entity Type:Organization
Organization Name:ORTHOPEDIC ASSOCIATES OF SW OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LAYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-415-9100
Mailing Address - Street 1:PO BOX 713130
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45271-3130
Mailing Address - Country:US
Mailing Address - Phone:937-415-9100
Mailing Address - Fax:
Practice Address - Street 1:2100 EMMANUEL WAY STE A
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45502-7218
Practice Address - Country:US
Practice Address - Phone:800-824-9861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOPEDIC ASSOCIATES OF S W OHIO, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty