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Individual

DR. THOMAS JOSEPH BAKONDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 WATERSIDE CT, COLUMBIANA, OH 44408-9661
(330) 206-2736
Mailing address
101 WATERSIDE CT, COLUMBIANA, OH 44408-9661
(330) 206-2736

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2008-01950
NC
2085R0202X
Diagnostic Radiology Physician
Primary
21296
MS
2085R0202X
Diagnostic Radiology Physician
A102115
CA
2085R0202X
Diagnostic Radiology Physician
M8517
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1518158773
BLUE CROSS BLUE SHIELD
TX
05
203653501
TX
Enumeration date
08/05/2007
Last updated
05/09/2012
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