Provider Demographics
NPI:1689075277
Name:PARAMOUNT DEVELOPMENT ASSOCIATION
Entity Type:Organization
Organization Name:PARAMOUNT DEVELOPMENT ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGO
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:BIBLICAL COUNSELOR
Authorized Official - Phone:937-263-8176
Mailing Address - Street 1:1818 WEST THIRD STREET
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417
Mailing Address - Country:US
Mailing Address - Phone:937-263-8176
Mailing Address - Fax:937-263-8175
Practice Address - Street 1:1818 WEST THIRD STREET
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417
Practice Address - Country:US
Practice Address - Phone:937-263-8176
Practice Address - Fax:937-263-8175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty