Provider Demographics
NPI:1861519019
Name:SURGICAL CONSULTANTS OF DAYTON INC
Entity type:Organization
Organization Name:SURGICAL CONSULTANTS OF DAYTON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:P
Authorized Official - Last Name:MEADOWS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-228-1731
Mailing Address - Street 1:1222 S PATTERSON BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-2684
Mailing Address - Country:US
Mailing Address - Phone:937-228-1731
Mailing Address - Fax:937-228-7827
Practice Address - Street 1:1222 S PATTERSON BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-2684
Practice Address - Country:US
Practice Address - Phone:937-228-1731
Practice Address - Fax:937-228-7827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0868655Medicaid
OH0868655Medicaid