Individual
JOSEPH D. DICICCO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D. O.
Contact information
Practice address
4160 LITTLE YORK RD, STE. 10, DAYTON, OH 45414-5800
(937) 415-9100
(937) 415-9191
Mailing address
PO BOX 713130, CINCINNATI, OH 45271-0001
(937) 415-9100
(937) 415-9191
Taxonomy
Speciality
Code
Description
License number
State
207XX0801X
Orthopaedic Trauma Physician
Primary
5545
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0264539
—
OH
01
—
930051658
RAILROAD MEDICARE
OH
01
—
P00657292
RR MEDICARE
OH
Enumeration date
08/10/2005
Last updated
03/16/2012
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