Individual
JAMES P. BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
335 GLESSNER AVE, MANSFIELD, OH 44903-2269
(419) 524-8151
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35-05-0204-B
OH
207RC0000X
Cardiovascular Disease Physician
Primary
35.050204
OH
207RI0011X
Interventional Cardiology Physician
35.050204
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0687092
—
OH
Enumeration date
08/09/2005
Last updated
09/08/2023
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