Alliance Physician Inc

Organization Active NPI Surgery Physician · Centerville, OH

NPI 1487936795 · NPPES record last updated Nov 12, 2012

Key facts

NPI
1487936795
Entity type
Organization (NPI type 2)
Primary specialty
Surgery Physician 208600000X
Legal business name
ALLIANCE PHYSICIAN INC
Practice address
2717 Miamisburg Centerville Rd
Suite 201
Centerville, OH 45459-3797
Phone
(937) 434-3180
Fax
(937) 434-9807
NPI assigned
Sep 13, 2011
Organization subpart
Yes
Parent organization (as reported)
ALLIANCE PHYSICIAN INC

Authorized official

Name
Daniel D Haibach
Title
Director Business Development
Phone
(937) 558-3222

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Centerville Family Prac (77 organizations share this tax ID)
Part of
Centerville Family Prac

Locations

2717 Miamisburg Centerville Rd
Ste 201
Centerville, OH 45459
Phone (937) 434-3180

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208600000X Yes

Addresses

Primary practice location

2717 Miamisburg Centerville Rd
Suite 201
Centerville, OH 45459-3797

Mailing address

2110 Leiter Rd
Miamisburg, OH 45342-3660
Phone (937) 384-4838

Other identifiers

IdentifierTypeStateIssuer
2712872MedicaidOH

Other names

  • Sycamore Surgical Associates Doing business as

Other providers in Centerville, OH

All providers in Centerville, OH · Surgery Physician in Ohio

Sources for this page

Verify at the official NPI Registry.