# JILA S WAIKHOM M D &ASSOCIATES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** none
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831167188
- **Authorized official:** JILA S WAIKHOM M.D. (PRESIDENT)
- **Authorized official phone:** (937) 426-8235

## Contact information

- **Practice address:** 440 SUGARBROOK TRL, BELLBROOK, OH 45305-9760
- **Practice address phone:** (937) 426-8235
- **Mailing address:** 440 SUGARBROOK TRL, BELLBROOK, OH 45305-9760
- **Mailing address phone:** (937) 426-8235

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 35036762 | OH | Yes |

## Other

- **Enumeration date:** 03/11/2006
- **Last updated:** 10/27/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0471903 | — | OH |