Basic Information
| Provider Information | |||||||||
| NPI: | 1134366149 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SEMON | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | R. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 128 E APPLE ST | ||||||||
| Address2: | SUITE 7000 | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454092902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372088322 | ||||||||
| FaxNumber: | 9372082105 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 E APPLE ST | ||||||||
| Address2: | SUITE 5253 | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454092939 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372082552 | ||||||||
| FaxNumber: | 9372084286 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2009 | ||||||||
| LastUpdateDate: | 07/13/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 34.011898 | OH | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.