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Individual

JOHN R. JAKUBEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4147 WESTFORD DR, CANFIELD, OH 44406-8086
(330) 702-1489
(330) 702-1545
Mailing address
4135 BOARDMAN CANFIELD RD, SUITE 101, CANFIELD, OH 44406-9803
(330) 286-5330
(330) 286-5396

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35-049919
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050028962
MEDICARE RAILROAD
OH
05
0578085
OH
Enumeration date
06/21/2006
Last updated
09/22/2014
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