Individual
BRENT WILSON IMBODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
330 N MAIN ST, CENTERVILLE, OH 45459-4465
(937) 435-1445
(937) 439-7552
Mailing address
136 S LUDLOW ST, DAYTON, OH 45402-1813
(937) 499-8262
(937) 223-9811
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35.063723
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0909057
—
OH
Enumeration date
10/03/2005
Last updated
05/25/2016
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