Provider Demographics
NPI:1558361329
Name:STEPHEN GREER DO INC
Entity Type:Organization
Organization Name:STEPHEN GREER DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:937-223-2911
Mailing Address - Street 1:131 N LUDLOW ST
Mailing Address - Street 2:SUITE 1125
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-1116
Mailing Address - Country:US
Mailing Address - Phone:937-223-2911
Mailing Address - Fax:937-461-5102
Practice Address - Street 1:131 N LUDLOW ST
Practice Address - Street 2:SUITE 1125
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1116
Practice Address - Country:US
Practice Address - Phone:937-223-2911
Practice Address - Fax:937-461-5102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-30102086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0682480Medicaid
OHGR0606597Medicare ID - Type Unspecified
OH0682480Medicaid
OHST9308611Medicare ID - Type Unspecified