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Alliance Physicians Inc

Organization Active NPI Urology Physician · Kettering, OH

NPI 1306128608 · NPPES record last updated Oct 4, 2019

Key facts

NPI
1306128608
Entity type
Organization (NPI type 2)
Primary specialty
Urology Physician 208800000X
Legal business name
ALLIANCE PHYSICIANS INC
Practice address
10 Southmoor Cir NW
Kettering, OH 45429-2486
Phone
(937) 294-1489
Fax
(937) 297-6468
NPI assigned
Sep 13, 2011
Organization subpart
Yes
Parent organization (as reported)
ALLIANCE PHYSICIAN INC

Authorized official

Name
Timothy Y Ko
Title
Cfo
Phone
(937) 558-3223

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031118000529 OH Part B Supplier - Clinic/Group Practice 0840104360 Receives reassigned benefits from 528 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

Part of
Centerville Family Prac

Locations

10050 Innovation Dr
Ste 200
Miamisburg, OH 45342
Phone (937) 558-3208

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 208800000X Yes

Addresses

Primary practice location

10 Southmoor Cir NW
Kettering, OH 45429-2486

Mailing address

10050 Innovation Dr
Suite 200
Miamisburg, OH 45342-4931
Phone (937) 558-3208

Other identifiers

IdentifierTypeStateIssuer
0059480MedicaidOH

Other names

  • South Dayton Urology Doing business as

Other providers in Kettering, OH

All providers in Kettering, OH · Urology Physician in Ohio

Sources for this page

Verify at the official NPI Registry.