# BAC MEDICAL LLC

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

## Provider details

- **NPI number:** 1871484691
- **Authorized official:** EDWARD P CLACK DO (OWNER / PHYSICIAN)
- **Authorized official phone:** (937) 277-9371

## Contact information

- **Practice address:** 5900 N MAIN ST STE 3, DAYTON, OH 45415-3106
- **Practice address phone:** (937) 277-9371
- **Practice address fax:** (937) 277-7734
- **Mailing address:** 5900 N MAIN ST STE 3, DAYTON, OH 45415-3106
- **Mailing address phone:** (937) 277-9371

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/10/2025
- **Last updated:** 07/10/2025