Provider Demographics
NPI:1982668463
Name:HAND SURGERY ASSOCIATES
Entity Type:Organization
Organization Name:HAND SURGERY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:KLUG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-439-5503
Mailing Address - Street 1:5300 FAR HILLS AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2381
Mailing Address - Country:US
Mailing Address - Phone:937-439-5503
Mailing Address - Fax:937-439-5286
Practice Address - Street 1:5300 FAR HILLS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-2381
Practice Address - Country:US
Practice Address - Phone:937-439-5503
Practice Address - Fax:937-439-5286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0546707Medicaid
OH=========OtherFEDERAL ID#