# ALLIANCE PHYSICIAN INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ALLIANCE PHYSICIAN INC
- **Other names:** Kettering Cardiothoracic & Vascular Surgeons
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1518249812
- **Legal business name:** ALLIANCE PHYSICIAN INC
- **Authorized official:** DANIEL D HAIBACH (DIRECTOR BUSINESS DEVELOPMENT)
- **Authorized official phone:** (937) 558-3222

## Contact information

- **Practice address:** 3533 SOUTHERN BLVD, SUITE 5650, KETTERING, OH 45429-1263
- **Practice address phone:** (937) 294-3611
- **Practice address fax:** (937) 294-9010
- **Mailing address:** 2110 LEITER RD, MIAMISBURG, OH 45342-3660
- **Mailing address phone:** (937) 384-4838
- **Mailing address fax:** (937) 384-4845

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/13/2011
- **Last updated:** 09/13/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2712872 | — | OH |