Provider Demographics
NPI:1144593724
Name:DAYCLINIC INC.
Entity Type:Organization
Organization Name:DAYCLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AYOKUNLE
Authorized Official - Middle Name:O
Authorized Official - Last Name:FATADE
Authorized Official - Suffix:
Authorized Official - Credentials:DO,
Authorized Official - Phone:276-252-7007
Mailing Address - Street 1:251 SAINT JOHNS CIR
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-6075
Mailing Address - Country:US
Mailing Address - Phone:276-252-7007
Mailing Address - Fax:
Practice Address - Street 1:4722 VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-7246
Practice Address - Country:US
Practice Address - Phone:276-252-7007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-13
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11475261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care