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Individual

DR. JASON TODD BAKICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
515 UNION AVE, SUITE 147, DOVER, OH 44622-3004
(330) 339-6233
(330) 364-8460
Mailing address
515 UNION AVE, SUITE 147, DOVER, OH 44622-3004
(330) 339-6233
(330) 364-8460

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36003043
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2251290
OH
01
480034101
RAILROAD MEDICARE
OH
Enumeration date
01/03/2006
Last updated
09/07/2011
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