Organization
DANNY L REVEAL, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANNY LEE REVEAL M.D. (PRESIDENT)
(937) 293-2300
Entity
Organization
Contact information
Practice address
2300 FAR HILLS AVE, DAYTON, OH 45419-1550
(937) 293-2300
(937) 293-2331
Mailing address
2300 FAR HILLS AVE, DAYTON, OH 45419-1550
(937) 293-2300
(937) 293-2331
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35037072
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG5697
MEDICARE RAILROAD
OH
Enumeration date
03/21/2007
Last updated
04/24/2008
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