Basic Information
| Provider Information | |||||||||
| NPI: | 1073787537 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DILEY MEDICAL GROUP LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 475 HILL RD N | ||||||||
| Address2: | SUITE C | ||||||||
| City: | PICKERINGTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431471157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6149491377 | ||||||||
| FaxNumber: | 6148636164 | ||||||||
| Practice Location | |||||||||
| Address1: | 475 HILL RD N | ||||||||
| Address2: | SUITE C | ||||||||
| City: | PICKERINGTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431471157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6149491377 | ||||||||
| FaxNumber: | 6148636164 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2008 | ||||||||
| LastUpdateDate: | 04/16/2008 | ||||||||
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| AuthorizedOfficialLastName: | WHITT | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | EDWARD | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6149491377 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 34-00-7003W | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.