| Alliance Physician Inc | |
|
405 W Grand Ave Psychiatric Unit Dayton OH 45405-4720 | |
| (937) 723-3312 | |
| (937) 723-3498 |
| Full Name | Alliance Physician Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 405 W Grand Ave, Dayton, Ohio |
| Authorized Official Name and Position | Daniel D Haibach (DIRECTOR BUSINESS DEVELOPMENT) |
| Authorized Official Contact | 9375583222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Physician Inc 2110 Leiter Rd Miamisburg OH 45342-3660 Ph: (937) 384-4838 | Alliance Physician Inc 405 W Grand Ave Psychiatric Unit Dayton OH 45405-4720 Ph: (937) 723-3312 |
| NPI Number | 1114209517 |
|---|---|
| Provider Enumeration Date | 09/13/2011 |
| Last Update Date | 09/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114209517 | NPI | - | NPPES |
| 2712872 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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