Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 47049 | OH |
NPI | 1003938523 |
---|---|
Provider Name | Jayne Dye |
First Address | Lancaster, OH 43130-3032 |
Second Address | Lancaster, OH 43130-3032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 08/07/2007 |