Provider Demographics
NPI:1649767740
Name:QUILING, JANNA (MSC, DO)
Entity Type:Individual
Prefix:DR
First Name:JANNA
Middle Name:
Last Name:QUILING
Suffix:
Gender:F
Credentials:MSC, DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 W GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-7538
Mailing Address - Country:US
Mailing Address - Phone:937-723-3245
Mailing Address - Fax:
Practice Address - Street 1:405 W. GRAND AVENUE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405
Practice Address - Country:US
Practice Address - Phone:937-723-3245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.014396207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program