| Dr Emmett H Broxson Jr, MD | |
|
1 Childrens Plz, Dayton, OH 45404-1898 | |
| (937) 641-3111 | |
| (937) 641-5885 |
| Full Name | Dr Emmett H Broxson Jr |
|---|---|
| Gender | Male |
| Speciality | Pediatrics - Pediatric Hematology-oncology |
| Location | 1 Childrens Plz, Dayton, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013023035 | NPI | - | NPPES |
| 0828715 | Medicaid | OH | |
| 0828715 | Other | OH | BCMH |
| 35056878 | Other | ND | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080P0207X | Pediatrics - Pediatric Hematology-oncology | 35056878 (Ohio) | Primary |
| Entity Name | Presbyterian Healthcare Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104802354 PECOS PAC ID: 9234041708 Enrollment ID: O20031103000603 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Emmett H Broxson Jr, MD 7570 Deep Woods Ct, Springboro, OH 45066-8570 Ph: (937) 748-4534 | Dr Emmett H Broxson Jr, MD 1 Childrens Plz, Dayton, OH 45404-1898 Ph: (937) 641-3111 |
Hemanth Shimoga Lingadevaru, MD,MPH,FAAP Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Plz, Dayton, OH 45404 Phone: 937-641-3000 Fax: 937-641-3107 | |
Tanya Paul, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Plz, Dayton, OH 45404 Phone: 937-641-3600 Fax: 937-641-5802 | |
Dr. Sara Frances Guerrero-duby, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1010 Valley St, Dayton, OH 45404 Phone: 937-641-4000 Fax: 937-641-4500 | |
Dr. Rory Jon Peppard, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Wyoming St, Neonatology Office, Dayton, OH 45409 Phone: 937-208-2907 Fax: 937-208-4515 | |
Dr. Ramakrishna Mutyala, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Plz, Dayton, OH 45404 Phone: 937-641-4000 Fax: 934-641-4500 | |
Bryce Lawrence Willen, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Plz, Dayton, OH 45404 Phone: 937-641-3600 Fax: 937-641-5802 |