Provider Demographics
NPI:1417215138
Name:LAYBA, CATHLINE JO (MD)
Entity Type:Individual
Prefix:
First Name:CATHLINE
Middle Name:JO
Last Name:LAYBA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:725 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45324-2640
Mailing Address - Country:US
Mailing Address - Phone:937-245-7200
Mailing Address - Fax:937-245-7999
Practice Address - Street 1:30 E APPLE ST STE 5253
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409
Practice Address - Country:US
Practice Address - Phone:937-208-6810
Practice Address - Fax:937-208-2030
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10044576208600000X
OH35.134343208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery