# DAYTON INTERVENTIONAL RADIOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316923915
- **Authorized official:** GREGG MILLER MD (SR. VICE PRESIDENT)
- **Authorized official phone:** (610) 644-8900

## Contact information

- **Practice address:** 3075 GOVERNORS PLACE BLVD, KETTERING, OH 45409-1323
- **Practice address phone:** (937) 765-3113
- **Mailing address:** PO BOX 412865, BOSTON, MA 02241-2865
- **Mailing address phone:** (610) 644-8900
- **Mailing address fax:** (484) 924-0053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 36.003246 | OH | — |

## Other

- **Enumeration date:** 12/16/2005
- **Last updated:** 10/13/2021