Provider Demographics
NPI:1568633980
Name:DAYTON OSTEOPATHIC HOSPITAL
Entity Type:Organization
Organization Name:DAYTON OSTEOPATHIC HOSPITAL
Other - Org Name:JOLSIN DIABETES CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:HAIBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-384-4836
Mailing Address - Street 1:PO BOX 71-4828
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43271-0001
Mailing Address - Country:US
Mailing Address - Phone:937-401-7575
Mailing Address - Fax:937-226-3200
Practice Address - Street 1:1989 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:SUITE 304
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-3859
Practice Address - Country:US
Practice Address - Phone:937-401-7575
Practice Address - Fax:937-226-3200
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAYTON OSTEOPATHIC HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty