GOVERNOR'S PLACE AMBULATORY SURGERY CENTER LLC - NPI 1073828315

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

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About Governor's Place Ambulatory Surgery Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GOVERNOR'S PLACE AMBULATORY SURGERY CENTER LLC (NPI 1073828315) is a healthcare organization registered as an ambulatory surgical in Dayton, Ohio and active in the NPI registry since August 2010. The organization lists Heidi B Donnelly, Owner/president Ceo, as its authorized official.

NPPES Registry Identity

NPI1073828315

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameGOVERNOR'S PLACE AMBULATORY SURGERY CENTER LLC

Location Address3025 GOVERNORS PLACE BLVDDayton, OH 45409-1330

Mailing Address3025 Governors Place BlvdDayton, OH 45409-1330 · (937) 293-5567 · Fax (937) 293-5568

Phone(937) 293-5567

Fax(937) 293-5568

Organization SubpartNo

Authorized OfficialHeidi B DonnellyOwner/president Ceo · (937) 293-5567

Enumeration DateAugust 11, 2010

✔ NPI 1073828315 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

License✔ Licensed in OH · 1936460

3025 GOVERNORS PLACE BLVD, Dayton, OH 45409

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Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARTHA A HICKMANN MD

Dermatology (Procedural Dermatology)