Provider Demographics
NPI:1184698458
Name:NEPHROLOGY ASSOCIATES OF DAYTON INC
Entity type:Organization
Organization Name:NEPHROLOGY ASSOCIATES OF DAYTON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:K
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-312-6550
Mailing Address - Street 1:7700 WASHINGTON VILLAGE DR
Mailing Address - Street 2:SUIT 220
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459
Mailing Address - Country:US
Mailing Address - Phone:937-438-0099
Mailing Address - Fax:937-438-0902
Practice Address - Street 1:7700 WASHINGTON VILLAGE DR
Practice Address - Street 2:SUITE 230
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459
Practice Address - Country:US
Practice Address - Phone:937-438-3132
Practice Address - Fax:937-438-8707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2386930Medicaid
OH0912856Medicaid
OH2045049Medicaid
OH2282346Medicaid
OHNE9255831Medicare ID - Type UnspecifiedHUBER HEIGHTS LOCATION
OH2282346Medicaid
OHNE9255835Medicare ID - Type UnspecifiedEATON LOCATION
OH0912856Medicaid