Provider Demographics
NPI:1881702132
Name:ORTHOPEDIC ASSOCIATES OF DAYTON
Entity type:Organization
Organization Name:ORTHOPEDIC ASSOCIATES OF DAYTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-280-4988
Mailing Address - Street 1:7980 N MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-2328
Mailing Address - Country:US
Mailing Address - Phone:937-280-4988
Mailing Address - Fax:937-280-4994
Practice Address - Street 1:7980 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-2328
Practice Address - Country:US
Practice Address - Phone:937-280-4988
Practice Address - Fax:937-280-4994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2358283Medicaid
OH0407980001Medicare NSC