| South Dayton Family Physicians | |
|
1525 E Stroop Rd Suite 200 Kettering OH 45429-5065 | |
| (937) 208-7400 | |
| (937) 208-7405 |
| Full Name | South Dayton Family Physicians |
|---|---|
| Speciality | Family Medicine |
| Location | 1525 E Stroop Rd, Kettering, Ohio |
| Authorized Official Name and Position | Kenneth Prunier (CEO/PRESIDENT) |
| Authorized Official Contact | 9372088213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Dayton Family Physicians 1525 E Stroop Rd Suite 200 Kettering OH 45429-5065 Ph: (937) 208-7400 | South Dayton Family Physicians 1525 E Stroop Rd Suite 200 Kettering OH 45429-5065 Ph: (937) 208-7400 |
| NPI Number | 1922051994 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 08/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922051994 | NPI | - | NPPES |
| 0160169 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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