Basic Information
| Provider Information | |||||||||
| NPI: | 1578569273 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HAND AND RECONSTRUCTIVE SURGEONS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2350 MIAMI VALLEY DR | ||||||||
| Address2: | STE 310 | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454594778 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9374354263 | ||||||||
| FaxNumber: | 9372989459 | ||||||||
| Practice Location | |||||||||
| Address1: | 2350 MIAMI VALLEY DR | ||||||||
| Address2: | STE 310 | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454594778 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9374354263 | ||||||||
| FaxNumber: | 9372989459 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2005 | ||||||||
| LastUpdateDate: | 05/12/2010 | ||||||||
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| AuthorizedOfficialLastName: | DANIS | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9374354263 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0105X | 35050076 | OH | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Surgery of the Hand |
ID Information
| ID | Type | State | Issuer | Description | 0877850 | 05 | OH | MEDICAID |