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Individual

DR. STEPHEN N CAJACOB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1034 W MARKET ST, LIMA, OH 45805-2730
(419) 228-8116
(419) 228-1160
Mailing address
1034 W MARKET ST, LIMA, OH 45805-2730
(419) 228-8116
(419) 228-1160

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2935T377
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000129223
ANTHEM PROVIDER NUMBER
OH
01
0159570001
MEDICARE DMERC
OH
05
0231270
OH
Enumeration date
07/19/2005
Last updated
01/17/2008
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