Doctor Name: | DR. JOHN H. DIRCKX |
NPI Number: | 1063737815 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 35.027266 |
Business Practice Address: | 260 Ravelle Ct Dayton, OH - 454201894 |
Business Phone Number: | 9372580499 |
Business Fax Number: | |
Mailing Address: | 260 Ravelle Ct, DAYTON |
State: | OH |
Postal Code: | 454201894 |
Phone Number: | 9372580499 |
Fax Number: | |
NPI Enumeration Date: | 04/05/2010 |
NPI Last Update Date: | 04/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 35.027266 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |