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Alliance Physician Inc

Organization Active NPI Surgical Physician Assistant · Kettering, OH

NPI 1891077293 · NPPES record last updated Sep 13, 2011

Key facts

NPI
1891077293
Entity type
Organization (NPI type 2)
Primary specialty
Surgical Physician Assistant 363AS0400X
Legal business name
ALLIANCE PHYSICIAN INC
Practice address
3535 Southern Blvd
Suite B
Kettering, OH 45429-1221
Phone
(937) 298-4331
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) 914-7094

Corporate family (same tax ID) 18

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

3535 Southern Blvd
Ste B
Kettering, OH 45429
Phone (937) 298-4331

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant
Group: 193400000X SINGLE SPECIALTY GROUP		 363AS0400X Yes

Addresses

Primary practice location

3535 Southern Blvd
Suite B
Kettering, OH 45429-1221

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
2712872MedicaidOH

Other names

  • Kettering Medical Center - Breast Evaluation Center Doing business as

Other providers in Kettering, OH

All providers in Kettering, OH · Surgical Physician Assistant in Ohio

Sources for this page

Verify at the official NPI Registry.