Individual
TIMOTHY DEKONINCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3525 SOUTHERN BLVD, 3525 SOUTHERN BLVD., KETTERING, OH 45429-1221
(937) 395-8839
(937) 395-8387
Mailing address
1 WYOMING ST, DAYTON, OH 45409-2711
(937) 208-3356
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35.139183
OH
Other
Enumeration date
04/27/2017
Last updated
08/19/2020
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