Organization
JASON T BAKICH DPM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON T BAKICH DPM (OWNER)
(440) 899-4399
Entity
Organization
Contact information
Practice address
29101 HEALTH CAMPUS DR, WESTLAKE, OH 44145-5270
(440) 899-4399
Mailing address
29101 HEALTH CAMPUS DR, WESTLAKE, OH 44145-5270
(440) 899-4399
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36003043
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2882939
—
OH
01
—
DH1917
RAILROAD MEDICARE
OH
Enumeration date
10/24/2007
Last updated
03/02/2011
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