Individual
DR. JEFFREY L MIKUTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1 CHILDRENS PLZ, DAYTON, OH 45404-1815
(937) 641-4000
(937) 641-4500
Mailing address
1 CHILDRENS PLZ, DAYTON, OH 45404-1815
(937) 641-3000
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
34.005638
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05279
PARAMOUNT
OH
01
—
0917664
BCMH
OH
05
—
0917664
—
OH
05
—
200533320
—
IN
01
—
200567
UNISON
OH
01
—
278476
AMERIGROUP
OH
01
—
311676182027
CARESOURCE
OH
01
—
326196
ONE NATION
OH
01
—
4329917
AETNA
OH
05
—
64117427
—
KY
01
—
738694
BUCKEYE
OH
Enumeration date
06/07/2006
Last updated
10/19/2021
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