Provider Demographics
NPI:1558317982
Name:DAVUE OB/GYN ASSOCIATES, INC.
Entity Type:Organization
Organization Name:DAVUE OB/GYN ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE COORDINATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-274-5420
Mailing Address - Street 1:9000 N MAIN ST
Mailing Address - Street 2:SUITE 232
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-1180
Mailing Address - Country:US
Mailing Address - Phone:937-274-5420
Mailing Address - Fax:937-832-9354
Practice Address - Street 1:9000 N MAIN ST
Practice Address - Street 2:SUITE 232
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-1180
Practice Address - Country:US
Practice Address - Phone:937-274-5420
Practice Address - Fax:937-832-9354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0208788Medicaid
OHDA9272101Medicare ID - Type Unspecified