Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 35.134467 | OH |
NPI | 1023376845 |
---|---|
Provider Name | Dr. Blake Thomas Daney |
First Address | Centerville, OH 45459-7021 |
Second Address | Centerville, OH 45459-7021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2012 |
Last Update Date | 02/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0305102 | (05) | OH |