Organization
OHIO VALLEY ENT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA DEWITT (ADMIN SUPERVISOR)
(937) 325-8796
Entity
Organization
Contact information
Practice address
435 S BURNETT RD, SPRINGFIELD, OH 45505-2717
(937) 325-8796
(937) 325-3640
Mailing address
435 S BURNETT RD, SPRINGFIELD, OH 45505-2717
(937) 325-8796
(937) 325-3640
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0429852
—
OH
01
—
CB1116
RAILROAD MEDICARE
OH
Enumeration date
01/31/2006
Last updated
12/15/2020
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